Exploring the Rotator Cuff

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Where is it?

The rotator cuff is located in the shoulder or glenohumeral joint. The glenoid is the surface of the shoulder blade which meets the upper arm bone (humerus) to form the shoulder joint. The rotator cuff muscles cover the surfaces of the shoulder blade (scapula) and then become tendonous as they insert (attach) onto the humerus.

What is it?

The rotator cuff is a term used to describe four major shoulder muscles; the supraspinatus, infraspinatus, teres minor and subscapularis. Functionally, rotator cuff muscles work to keep the shoulder joint together as you lift and use you arms. This type of stability is key to raising your arms over head. These rotator cuff muscles work together at low intensity during your daily activities. When washing windows for spring cleaning, the rotator cuff may fatigue and cause your shoulder to ache. This is because the rotator cuff has to coordinate every “sweep” motion. The rotator cuff muscles are able to function individually and allow reaching across the body (adduction and internal rotation) as well as reaching to put on a jacket (external rotation and extension).

Is that why my shoulder hurts?

Possibly. The rotator cuff muscles can cause pain within the shoulder joint, into the neck, and down the arm. These muscles are notorious for referring pain as shown by the trigger point images. The rotator cuff is critical to your daily function and a small injury or irritation can really impact your life. The rotator cuff can also be irritated by overuse. For example, in Wisconsin many golfers have limited swings during the winter. Finally getting back on the course and playing 18 or 36 holes in a weekend can cause some serious shoulder irritation. Checking with a PT can get your shoulder (and body) ready for the golf course and other spring activities.

What do I do?

If you fell on the ice or had an injury to your shoulder and it still hurts, you should see your physical therapist or your primary physician. If you have increased your activity and have irritation in your shoulder you should stop in for physical therapy, occupational therapy or a free consultation. Some rotator cuff strains and irritations will get better with relative decrease in activity and ice. This should occur in 1-2 weeks. I recommend checking in with your physician, PT or OT if your shoulder does not feel better in 2 weeks. Rotator cuff injuries can get worse without treatment and early treatment has the potential to prevent surgery.

For more information, check out this guide on Rotator Cuff Tendinitis.

-Rachel Thiel, Doctor of Physical Therapy
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