A rotator cuff tear is a complete or partial tear to any one of the four rotator cuff muscles. The acronym for the rotator cuff muscles is SITS. This stands for supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles are responsible for most of the motion of the shoulder, primarily rotation. They all begin at different parts of the scapula (shoulder blade bone) and converge into one tendon which attaches to the upper end of the humerus (upper arm bone). There are many other muscles that are involved with the great degree of motion in the shoulder, but these four muscles are the foundation which makes the movement stable, smooth, and complete.

By far, the most commonly injured muscle when an individual is experiencing rotator cuff pain is the supraspinatus. This muscle sits on the top of the shoulder joint and its primary action is to support abduction of the humerus. This means lifting your arm out to the side. The infraspinatus sits below the supraspinatus on the bulk of the shoulder blade and its job is to externally rotate the arm. External rotation is the action of turning your arm outward. The teres minor is a small muscle that attaches to the edge of the shoulder on the outer edge and also provides support with external rotation. The subscapularis sits on the underside of the scapular facing the ribs and its job is to internally rotate the arm, which is turning your arm inward.

Anything from an awkward motion of your arm to a traumatic event can cause a rotator cuff tear. Overuse injuries from repetitive motions are also a common cause of a rotator cuff tear. The causes of rotator cuff tears can be:

● Overuse injuries (commonly seen in baseball players, specifically pitchers, who are rotating their shoulder hundreds of times a day)
● Traumatic injury from a sports related injury or motor vehicle accident
● Age – normal degeneration and wear and tear of the muscle, weakening it
● Bone spurs also related to aging cause an unnatural rubbing and wearing away of a rotator cuff muscle
● Genetics can play a factor making some individuals more susceptible to rotator cuff tears
● Man view from back. Blades, shoulder and trapezoid illustration.

In women, a telltale sign of a rotator cuff injury is feeling pain when putting on their bra or brushing their hair. In men, a telltale sign is pain from putting on a belt or combing hair. All of these motions involve reaching behind your back or overhead with rotation. Other signs and symptoms may be:

● Significant pain the shoulder, that may be present even at rest and often greater at night
● Pain with reaching overhead and/or lowering the arm
● Decreased strength and pain with rotational movements of the shoulder
● Pain or weakness with holding your arm out to the side
● Cracking or grinding sound with certain motions

If You Are Experiencing Symptoms, Schedule an Appointment Dr. Burke Orthopedics Immediately.

These muscles are often overlooked. These are not large muscles but incredibly important to the function of your shoulder and it is vital to keep them strong. If a tear is not a complete tear, conservative measures will generally be attempted first with a course of physical therapy which will involve strengthening these muscles and restoring any lost range of motion and function.

In the case of what is referred to as a full thickness tear, a complete tear, surgery will most likely be required in order to repair the torn muscle.