Everything you need to know about the rotator cuff!
- Mar 29
- 3 min read
Updated: 2 days ago
Many sufferers experience severe discomfort from rotator cuff tears. The cuff consists of four tendons that surround the upper arm. Damage to these tendons can cause loss of strength and shoulder pain.
In this article you will learn:
Why rotator cuff tendons can tear.
What conservative treatment options exist.
How to prevent a rotator cuff tear.
When surgery is advisable for a tear.
Anatomical basics:
The rotator cuff consists of four muscles of the shoulder joint:
Supraspinatus muscle
Infraspinatus muscle
subscapularis muscle
M. teres minor
This is why the rotator cuff tears.
Parts of the rotator cuff run between the upper arm head (humerus) and the shoulder roof (acromion), the so-called subacromial space.
In this area, tendon damage can occur due to wear and tear. The supraspinatus tendon is most commonly affected, as it is particularly susceptible to pressure under the acromion when the arm is bent (impingement syndrome).
"Overload or a fall can cause the tendon to tear completely or partially."
Some wear and tear of the tendon with age is normal and doesn't necessarily cause symptoms. However, if the quality of the tendon is reduced, it can tear completely or partially due to excessive strain or a fall.
What can I do as a patient, how can I prevent a rotator cuff tear?
Generally, it's advisable to position your shoulders in your center. How do you do that?
Due to our "modern" posture, with increased desk work, cell phone use, etc., we tend to hunch our shoulders. This increases the pressure in the subacromial space, causing tendon damage more quickly.
"When we bend the arm, it is better to rotate it outwards from a low position to prevent damage to the supraspinatus tendon."
Through centering exercises, in which we train ourselves to pull the shoulder downwards, the pressure below the shoulder roof on the supraspinatus tendon is reduced.
When we bend the arm, it's also important to rotate it outward from a low position. Some people have to learn the feel for a centered shoulder position and the correct shoulder movement.
This is best done under the guidance of a good physiotherapist.
The awareness of good shoulder movement can also be trained in other ways, for example through our patient video "My shoulder is feeling better" (link).
However, there are also congenital components, such as the so-called "critical shoulder angle." This refers to an anatomically pronounced protrusion of the acromion. This increases the risk of rotator cuff damage. This can only be corrected through surgery.
In the event of a sports or work-related accident, the tendon can tear or, in extreme cases, rupture even without prior damage. Careful handling can help prevent this.
If you experience pain after a sports accident or if you experience pain that does not subside spontaneously over several weeks, it is always advisable to consult a shoulder specialist as early as possible in order to detect damage to the tendon as early as possible and to initiate countermeasures.
Once the tendon is torn, it can no longer heal to its original location on its own.
Then a rotator cuff tear should be operated on.
Most rotator cuff tears can be successfully treated without surgery.
Physiotherapy over several weeks helps many patients reduce pain and improve range of motion. However, if conservative therapy is unsuccessful, surgical treatment should be considered.
A prerequisite for successful tendon reconstruction is good tendon quality. If the tear has been present for a long time, the muscle may be so weakened that it shrinks, and the tendon tear can no longer be repaired.
To assess tendon quality, an ultrasound or magnetic resonance imaging (MRI) of the shoulder is usually necessary.
"If conservative therapy is unsuccessful, the possibility of surgical treatment can be considered."
Which therapy is most appropriate depends on the patient’s symptoms, the examination findings and the MRI findings.
In each case, an individual solution must be sought and found with the patient.
The patient's needs and desires for shoulder function are the focus. In addition to improving shoulder function, surgery can often also improve quality of life.
If the patient decides to have an operation, several preparations must be made, which take place as part of a detailed consultation and information session.
Conclusion
The rotator cuff is the “motor of the shoulder.”
Small cracks and signs of wear are common, but do not automatically require surgery.
Larger tears regularly lead to pain and decentration of the shoulder and should therefore be treated early.
Rotator cuff injuries can be easily detected using ultrasound and MRI.
If you have any questions, please schedule an appointment with our shoulder specialist :
Specialist in orthopedics
and trauma surgery,
Sports medicine
