Rotatorenmanschettendysfunktion

Rotatorenmanschaft, or rotator cuff, refers to the group of muscles and tendinous fibers that surround the shoulder joint. The four muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis. Their tendons blend with the joint capsule and attach to the humerus, stabilizing the glenohumeral joint and guiding shoulder movements.

The primary functions of the rotator cuff are to stabilize the upper arm within the shallow shoulder socket and to enable movement. The supraspinatus initiates shoulder abduction, while the infraspinatus and teres minor assist with external rotation, and the subscapularis controls internal rotation. The tendons pass beneath the acromion, contributing to the subacromial space and working with a bursa to reduce friction during motion.

Rotator cuff problems range from tendinopathy and bursitis to partial-thickness or full-thickness tears. Age-related degeneration, overuse—especially in repetitive overhead activities—trauma, and prior shoulder conditions increase risk. Symptoms commonly include lateral shoulder pain, weakness with lifting or reaching overhead, limited range of motion, and sometimes night pain.

Diagnosis is based on history, physical examination, and imaging. Physical tests may assess supraspinatus strength and external rotation, such as the empty-can test or the drop-arm test. Imaging options include ultrasound or magnetic resonance imaging to evaluate tendon integrity.

Treatment starts with nonoperative measures: activity modification, physical therapy focused on scapular control and rotator cuff strengthening, nonsteroidal anti-inflammatory drugs, and corticosteroid injections in selected cases. Surgery is considered for persistent symptoms or significant tears, typically via arthroscopic repair or debridement. In extensive cases or cuff tear arthropathy, alternative procedures, including reverse shoulder arthroplasty, may be indicated. Recovery and prognosis depend on tear size, tissue quality, and adherence to rehabilitation.