Rotator cuff tears affect the four muscles that support and stabilize the shoulder joint, causing limited arm movement. Tendonitis and tears are common injuries caused by overuse or trauma, while impingement is due to muscle imbalance. Treatment includes rest, anti-inflammatories, immobilization, and strengthening exercises.
Rotator cuff tears are injuries to the four muscles that collectively make up the rotator cuff: the teres minor, supraspinatus, infraspinatus, and subscapularis muscles. These muscles and their attaching tendons are responsible for supporting and stabilizing the glenohumeral joint, or shoulder. Specifically, they help hold the ball-shaped head of the humerus bone in the upper arm in the cavity of the scapula known as the glenoid fossa. Therefore, rotator cuff injuries will affect the function of the shoulder joint and thus severely limit arm movement.
The supraspinatus is the highest of the four, running horizontally from the top of the scapula to the top of the humerus, with the infraspinatus lying parallel to and just below the supraspinatus. Located below this is the teres minor, which originates lower on the scapula and runs somewhat diagonally to attach at the top of the humerus below the other two muscles. The subscapularis is the only one of the four that lies on the ventral or anterior side of the scapula, and is triangular in shape, its narrowest point inserting below the other muscles at the top of the humerus.
Rotator cuff tears most commonly affect the tendons that connect these muscles to the shoulder joint. One such injury is tendonitis, which is caused by overuse of the rotator cuff muscles through repetitive stress on the shoulder joint and is common in athletes who perform repetitive pitching motions, such as baseball pitchers. Tendinitis is inflammation of the attaching tendons that can become very painful and difficult to clear without adequate rest of the shoulder joint and avoidance of the movement patterns that caused it to develop. In addition to rest, treatment usually includes freezing the joint and taking over-the-counter anti-inflammatories such as ibuprofen.
Tears are another common type of rotator cuff injury. They are caused either by repetitive movements that break the tendon until it tears, or by a specific trauma to the shoulder. Rotator cuff tears can be much more debilitating than tendonitis, requiring immobilization of the arm until the injury heals. Compression or wrapping of the joint may also be recommended to reduce both motion and swelling, as can regular icing.
A final category of rotator cuff injury is impingement, which occurs when one or more muscles are pinched against the scapula, typically due to prolonged muscle imbalance leading to postural defects. As with any rotator cuff injury, impingement can be treated and prevented with regular strengthening exercises to restore normal upper body alignment and achieve optimal function. These exercises may include holding a light dumbbell or pulley and externally rotating the shoulder joint, as internal rotation is the most common imbalance. A highly recommended version of this exercise requires you to lie on your side with a dumbbell and, with your elbow held tightly to your side and bent 90 degrees, rotate your shoulder in and out to raise and lower the dumbbell. . This movement targets all four rotator cuff muscles.
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