What is the rotator cuff and why does it cause so much shoulder pain?

​​​What is it?
The rotator cuff is actually made up of 4 different muscles surrounding the shoulder: the infraspinatus, supraspinatus, subscapularis, and teres minor. These muscles collectively function to add compressive forces to the humeral head and contribute to stabilization of the glenohumeral (shoulder ball and socket) joint. They need to be strong and flexible in order to allow for full range of motion and function of the shoulder girdle.

How is it injured and treated?
These muscles are negatively affected by poor posture and positioning of the shoulder complex as well as weakness, and can be subject to overuse injuries and aggravation leading to small or large tears or tendonitis, which is inflammation. Often, patients respond well to conservative treatment including physical therapy, pain and inflammation management, and rest. In physical therapy, emphasis is placed on restoring proper biomechanics and joint movements, as well as addressing dysfunction and trigger points in the muscles. The muscles will then gradually be strengthened with proper form, including specific external and internal rotational strengthening, scapular stabilization, and overall functional strengthening.

​Sometimes, a steroid injection is required to help calm the area depending on the severity of the injury. If a severe tear is present, and conservative measures are unable to fully restore function and reduce pain, surgical intervention and repair may be required. Generally speaking, patients with minor tears and overuse injuries respond well to physical therapy interventions. Hope this helps you understand a little more about what the rotator cuff is and how it is treated.