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Anatomy of the Rotator Cuff

The rotator cuff consists of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles work together to hold the head of the humerus (upper arm bone) within the shallow socket of the shoulder blade. The tendons of these muscles form a cuff around the joint, allowing for a wide range of motion while also providing stability. The rotator cuff also helps to maintain proper alignment of the shoulder joint, preventing injury.

Causes and Risk Factors

As mentioned, rotator cuff tears can occur from acute trauma or develop gradually over time. Some common causes and risk factors for rotator cuff tears include:

  • Repetitive overhead motions
  • Age (most common in adults over 40)
  • Participation in sports that involve repetitive shoulder movements, such as baseball, tennis, and swimming
  • Poor posture or muscle imbalances
  • Previous shoulder injuries or surgeries
  • Genetics (some people may have a predisposition to developing rotator cuff tears)


Symptoms of a rotator cuff tear may include:

  • Pain or tenderness in the shoulder, especially when reaching overhead or behind the back
  • Weakness in the affected arm, making it difficult to lift objects or perform daily tasks
  • Limited range of motion in the shoulder joint
  • A popping or clicking sensation when moving the shoulder
  • Nighttime pain that disrupts sleep
  • Muscle atrophy in the affected arm if the tear is severe or long-standing

Diagnostic Process

If you are experiencing symptoms of a rotator cuff tear, your doctor will likely perform a physical examination to assess your range of motion and strength in your shoulder. They may also order imaging tests such as an X-ray or MRI to confirm the diagnosis and determine the severity of the tear. If necessary, your doctor may also recommend a shoulder arthroscopy, a minimally invasive procedure that uses small incisions and a camera to view and repair the tear.

Treatment Options

Conservative Care

Some rotator cuff tears can be treated without surgery. Some conservative treatment options include:

  • Rest: Avoid activities that aggravate the injury and give the shoulder time to heal
  • Ice: Applying ice to the affected area can help reduce pain and swelling
  • Physical Therapy: A physical therapist can work with you to develop a customized exercise program to improve strength and flexibility in the shoulder
  • Medications: Your doctor may prescribe pain relievers or anti-inflammatory drugs to help manage symptoms

Surgical Treatment

When conservative treatments fail to relieve pain or restore function, surgical intervention may be necessary for rotator cuff tears. At Excel Health, our surgical approaches prioritize repairing the torn tendon(s) and restoring shoulder stability and function. Techniques such as arthroscopic repair may be utilized to minimize the size of incisions and speed up recovery time. Your doctor will discuss the best course of treatment for your individual case.

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