Rotator Cuff Comic

The Rotator Cuff Revealed

Rotator Cuff ComicThe rotator cuff tear is one of the most common shoulder injuries. Here are some FAQs from patients newly diagnosed with a tear or who suspect a tear.

Q: What is the rotator cuff?!
A:  It is a group of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis. The supraspinatus muscle tendon is the most commonly torn.

Q: What is a muscle tendon?
A: It’s what connects the muscle to your bone.
Q: What does the rotator cuff do? 
A: Each muscle in the group plays its own role, but basically the rotator cuff helps to raise your arm, rotate your shoulder, and maintain the ball of your shoulder joint in the proper position.
Q: What causes rotator cuff tears?

A:  There are couple different ways your rotator cuff can be torn. People mostly think of a traumatic event leading to an injury. Shoulder pain, decreased strength and motion can come on suddenly with a specific event such as lifting something heavy or catching yourself from a fall. You may have had a tear prior to that event without any symptoms, and the event increased the size of your tear producing symptoms.
Q: I cannot think of anything specific that I did to my shoulder. How can I have a tear?Rotator Cuff Muscles
A: It’s not unusual for rotator cuff tears to develop over time with a gradual onset of symptoms. Non-traumatic tears are typically caused by repetitive overhead activities or ongoing shoulder impingement. Poor positioning of your shoulder blades (slumped posture) especially while performing reaching, lifting, and overhead activities can be a big factor in the development of a tear. Don’t follow Zeus’s example of posture.
Q: How can PT help if it’s torn?
A: Great results can be achieved with physical therapy especially in those with a non-traumatic tear. PT can gradually expose you to that motion lost improving your pain level and function. Strength can be gained in the muscle tissue with an intact tendon. If you ultimately chose surgery, PT would have helped to decrease your stiffness and weakness improving your outcomes post-op.

3 Fun Facts: The Rotator Cuff Tear

  1. A large percentage of rotator cuff tears are asymptomatic! Of all the people with a rotator cuff tear the majority have NO pain and NO difficulty with functioning in their daily life as a result.
  2. There is no significant difference in outcomes between those who had surgery and PT versus those who only had PT for a non-traumatic tear at one year follow-up. Be hopeful in physical therapy. 
  3. Your risk of getting a tear increases with age. About 37% of people in their 80s have developed a rotator cuff tear.
Resources:Chung, Seok Won, et al. “Shoulder stiffness after rotator cuff repair: risk factors and influence on outcome.” Arthroscopy: The Journal of Arthroscopic & Related Surgery 29.2 (2013): 290-300.
Kukkonen, J., et al. “Treatment of non-traumatic rotator cuff tears A randomised controlled trial with one-year clinical results.” Bone & Joint Journal 96.1 (2014): 75-81.
Minagawa, Hiroshi, et al. “Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: from mass-screening in one village.” Journal of orthopaedics 10.1 (2013): 8-12.
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