Injuries and Rehabilitation of the Rotator Cuff Muscles

The rotator cuff is comprised of four muscles. These individual muscles combine at the shoulder to form a thick "cuff" over the joint. The rotator cuff has the important job of stabilizing the shoulder as well as elevating and rotating the arm. Due to the location of the muscle tendons under the bony structures of the shoulder joint, they are at increased risk of injury. Rotator cuff tears make up the majority of rotator cuff disorders. For partial tears, conservative management, such as physical therapy, can be utilized. Occasionally the tear is too severe and surgical repair is required.

The Muscles of the Rotator Cuff

Four muscles form the rotator cuff. These are the:

• Supraspinatous
• Infraspinatous
• Teres Minor
• Subscapularis

The mnemonic “SITS” is often used to refer to these muscles.

Disorders of the Rotator Cuff
Rotator cuff tears result when the muscles and tendons of the rotator cuff become frayed under the acromion bone of the shoulder. This occurs both with aging as well as in younger people who perform repetitive overhead activities. Baseball pitchers as well as occupations that require overhead work are two examples of people at risk of sustaining rotator cuff tears.

Rotator Cuff Tear Rehabilitation

Conservative management of rotator cuff tears involve physical therapy to strengthen the muscle group. This type of therapy should be approved by a physician prior to its initiation.
Rotator Cuff Strengthening Exercises

Occasionally, tears are too severe for conservative management and will require surgical repair. This is often performed via an arthroscopic surgical procedure. After surgery, there is often a period of immobilization and movement restriction of the shoulder joint. During this period, the shoulder muscles can become weak. As a result, physical therapy will also be required after surgical repair of rotator cuff tears to restrengthen the muscles.
Shoulder Exercises After Arthroscopic Surgery

_Source:

Kier J. Ecklund, MD, Thay Q. Lee, PhD. “Rotator Cuff Tear Arthropathy” Journal of the American Society of Orthopedic Surgeons Vol 15, No 6, June 2007, 340-349.