The rotator cuff is made up of four muscles; Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. These muscles are attached via tendons onto the shoulder blade and then insert into the top part of the arm. Inflammation of the tendons is known as tendonitis, which can also be seen alongside shoulder impingement, and can be as a result of trauma or in repetitive overuse activities.
Injuries to the rotator cuff can range from simple contusions and tendonitis, to chronic injury, partial and full thickness tears. Rotator cuff injury can easily become chronic if it persists for longer than 12 weeks. After this time, the muscle weakens, retracts and fatty infiltrate develops. Chronic rotator cuff tendinopathy can occur due to extrinsic factors such as degenerative bursa or acromial bony growths, or intrinsically which include vascular changes, genetic disposition and overload.
From a management perspective, the majority of rotator cuff injuries (in the absence of full thickness tears) can be managed conservatively with physical therapy, anti-inflammatory medication, cortisone injections and rest/activity modification. However, when conservative methods have been exhausted after a 4-6 month period, then surgical intervention may be considered.