Rotatorcuffen

Rotatorcuffen, or the rotator cuff, is the group of four tendinous muscles that stabilize the shoulder joint: supraspinatus, infraspinatus, teres minor, and subscapularis. Their tendons blend with the joint capsule and attach to the proximal humerus, forming a cuff that helps center the head of the humerus during arm movement.

The rotator cuff enables a range of shoulder motions. The supraspinatus assists with initial lifting (abduction), while the infraspinatus and teres minor contribute to external rotation, and the subscapularis to internal rotation. Together they protect the joint from excessive translation during overhead activities.

Injuries to the rotator cuff include tendinopathy and partial or full-thickness tears. Degenerative changes with age, repetitive overhead work, trauma, and factors such as diabetes or smoking increase risk. Symptoms commonly include shoulder pain, weakness, limited range of motion, and sometimes night pain.

Diagnosis is based on history and physical examination, with tests such as the empty can and examination for weakness. Imaging, typically ultrasound or MRI, helps determine tear size and tendon quality.

Treatment starts with conservative measures: rest, ice, nonsteroidal anti-inflammatory drugs, and a guided rehabilitation program to restore mobility and strengthen supporting muscles. Corticosteroid injections may provide temporary relief. Large or persistent tears often require surgery, most commonly arthroscopic rotator cuff repair; less frequently open repair or tendon transfer. In advanced cases with cuff tear arthropathy, a reverse shoulder arthroplasty may be considered.

Prognosis depends on tear size, patient age, tissue quality, and adherence to rehab. Smaller tears often respond well to nonoperative care; larger tears carry higher risk of ongoing symptoms or re-tear after treatment.

Rotator cuff disease is common in adults over 40 and becomes more prevalent with age.