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Rotator Cuff Disease

Medical Author: William C. Shiel Jr., MD, FACP, FACR

What is the rotator cuff?

The rotator cuff is the group of four tendons that stabilize the shoulder joint. The tendons hook up to the four muscles that move the shoulder in various directions.

There are four muscles whose tendons form the rotator cuff: the subscapularis muscle, which moves the arm by turning it inward (internal rotation); the supraspinatus muscle, which is responsible for elevating the arm and moving it away from the body; the infraspinatus muscle, which assists the lifting of the arm during turning the arm outward (external rotation); and the teres minor muscle, which also helps in the outward turning of the arm.

What is rotator cuff disease?

Rotator cuff disease is damage to the rotator cuff from any cause. This condition is one of the most common causes of shoulder pain.

How is the rotator cuff injured?

The rotator cuff can be injured because of degeneration with aging or inflammation due to tendinitis, bursitis, or arthritis of the shoulder. The rotator cuff is commonly injured by trauma (such as from falling and injuring the shoulder or overuse in sports). Rotator cuff injury is particularly common in people who perform repetitive overhead motions that can stress the rotator cuff. These motions are frequently associated with muscle fatigue.

What are symptoms of rotator cuff disease?

The most common symptom of rotator cuff disease is shoulder pain. The pain is often noticed gradually and may be first noticed even a day after the actual event which may have caused the injury. Sometimes, a sudden pain occurs during a sport activity. The pain is usually located to the front and side of the shoulder and is increased when the shoulder is moved away from the body. The pain is usually noted to be more intense at nighttime and sometimes increases when lying on the affected shoulder. The pain can diminish and result in a frozen shoulder. There can also be tenderness in the area of the inflamed tendons of the injured rotator cuff.

People with rotator cuff disease usually find it difficult to lift the arm away from the body fully. If the rotator cuff disease involves severe tears of the rotator cuff tendons, it can be impossible for the patient to hold the arm up because of pain.



Next: How is rotator cuff disease diagnosed? »

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Rotator Cuff Disease

What is shoulder bursitis?

A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. The plural of bursa is bursae. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.

Bursitis is inflammation of a bursa. When injury or inflammation of a bursa around the shoulder joint occurs, shoulder bursitis is present.

How does a bursa become inflamed?

A bursa can become inflamed from injury, infection (rare in the shoulder), or an underlying rheumatic condition. Examples include infection of the bursa in front of the knee from a knee scraping on asphalt (septic prepatellar bursitis), inflammation of the elbow bursa from gout crystals (gouty olecranon bursitis), or injury as subtle as lifting a bag of groceries into the car, which could inflame the sh...

Read the Shoulder Bursitis article »











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