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Rotator Cuff: A Basic Intro

by Cathy Richey

The rotator cuff is a group of strong, ropelike fibers (tendons) and muscles in the shoulder. Rotator cuff disorders occur when tissues in the shoulder get irritated or injured. The rotator cuff keeps the upper arm bone in the shoulder socket and lets you raise and twist your arm.

The shoulder is a ball-and-socket joint. The ball at the top of the upper arm bone fits into the socket of the shoulder blade. This socket is shallow, and that construction lets you move your arm in a wide range of motion.

The downside is the muscles and tendons of the rotator cuff  work hard to hold the bones in place. Consequently, they are easy to injure and are prone to wear and tear.

Causes of disorders

Most rotator cuff disorders are caused by a combination of:

  • Normal wear and tear. Using your shoulder for many years slowly damages the rotator cuff. As you age, everyday activities can lead to changes in the rotator cuff, such as thinning and fraying of the tendons and decreased blood supply.
  • Overuse. Activities in which you use your arms above your head a lot, such as tennis, swimming, or house paintingócan lead to rotator cuff problems. Even normal motions made often over a long period can stress or injure the rotator cuff.

Both normal wear and tear and overuse can lead to impingement, which is what you have when a tendon rubs against bone. This damages and irritates the tendon, which causes bleeding and inflammation. Over time, scar tissue replaces healthy tissue, and the tendons become stiff, stringy, and more easily injured.

According to doctors at Mayo Clinic, poor posture, especially as related to your shoulders hunched forward, also can contribute to rotator cuff injury. As you get older, your risk of a rotator cuff injury increases.

Rotator cuff tears

It takes great force to actually tear a healthy rotator cuff tendon. However, such tears do happen. They can happen during sports, an accident, or a severe fall. But even a simple movement like lifting a suitcase can cause a rotator cuff tear in an older adult or someone whose shoulder is already damaged.

Symptoms of a rotator cuff disorder include pain, stiffness, and weakness in the shoulder. Most often, the pain is on the front and side of the shoulder and in the upper arm. It may hurt or be impossible to do everyday things, such as comb your hair, tuck in your shirt, or reach for something. You may have pain during the night and trouble sleeping. You may not be able to sleep on the affected shoulder.

Treatment for rotator cuff disorders focus on relieving pain and inflammation and restoring shoulder strength, flexibility, and function. Treatment may help to prevent further complications, such as loss of strength and movement in the shoulder or additional degeneration or tearing. Treatment considerations include your symptoms, age, activity level, and the severity of the rotator cuff disorder.


Early stages of rotator cuff damage are usually reversible with conservative treatment.

These treatments include the following:

  • Alternating applications of cold and heat or whichever helps more

  • Taking non-steroidal anti-inflammatory drugs

  • Avoiding positions and activities that hurt your shoulder

  • Exercise therapy  

Some recommended exercises


  • Scapular Retraction. Anchor tubing to a fixed object, hold each end in your hand. Squeeze and pinch your shoulder blades together, pulling your arms back.  Hold, return to start, and repeat. 

  • Horizontal Abduction:  With a hand weight, lie on stomach, start with arm hanging down and out from side. Hold, slowly return to start and repeat. 

  • Scapular Retraction and External Rotation:If using a weight, lie on stomach, with arm out to side hanging down with elbow bent at 90 degrees. Upper arm should be supported by the bed. Turn and rotate arm towards the ceiling while keeping the elbow bent at 90 degrees. Squeeze the shoulder blades together, hold, return to start.

More important facts about the rotator cuff

  • Many doctors overlook the true problem with a shoulder impingement. They treat the tendonitis (inflamed tendons) with anti-inflammatory agents or cortisone (steroid) injections. But the anti-inflammatories soon wear off, and the next time the individual throws a ball, the tendon is pinched or impinged again. The pain returns, requiring another injection of more anti-inflammatories.
  • The preferable way to treat a shoulder impingement is through an exercise program to strengthen the rotator cuff muscles sufficiently so that the head of the shoulder is held firmly in place and will not slip out of the socket. With no slipping, the tendons will no longer be inflamed or irritated.
  • You can strengthen your rotator cuff muscles initially at home with a free-weight program. Using 15 pounds as the absolute maximum weight, you should do the exercises until fatigue sets in or for 50 repetitions once a day.
  • Three out of four rotator cuff problems can be cured with simple exercises.

Keeping your rotator cuffs healthy

Remember, most of the time, treatment involves self-care measures and exercise therapy. So, do some gentle exercises to keep your shoulder muscles limber. Total inactivity can cause stiff joints. Favoring your sore shoulder for a long time can lead to frozen shoulder, a condition in which your shoulder becomes so stiff you can barely move it.

Once you have good range of motion in your shoulder, continue exercising. Daily shoulder stretches and a balanced shoulder-strengthening program can help prevent injury.

A systematic program of shoulder exercises can help prevent an injury to your rotator cuffs.

Follow the advice here, and you'll have healthy shoulders. That means you will prevent a significant amount of pain, both physical and financial.

About the author: Cathy and her Doberman Trooper conduct research into all kinds of topics and produce articles like the one you see here. To contact Cathy, write to Get the facts from Cathy, and let the Cathy Factor give you an edge.



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