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Many people with shoulder problems have been told that they have injured their rotator cuff, but many times are not told what that is.  In fact, I hear all sorts of variations on the term “rotator cuff” - including “rotator cup”, “rotary cuff”, “rotary cup”, etc., so I know that many people are unfamiliar with what exactly is wrong.

 The rotator cuff is a group of 4 muscles that are run from the shoulder blade area to the top of the humerus (upper arm bone).  The four muscles are sometimes referred to as the “SITS” muscles, which is an acronym for Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis.  Although any of these muscles could technically be involved in a rotator cuff injury, nearly all rotaor cuff injuries primarily involve the supraspinatus, and primarily the tendon portion of the supraspinatus. 

The main portion of the supraspinatus lies in a groove in the top of the shoulder blade and it’s tendon then runs through a “tunnel” underneath the outer corner of the shoulder blade and the outer end of the collarbone and attaches to the upper arm bone.  The primary function of the supraspinatus and the rotator cuff in general is to raise and outwardly rotate the shoulder joint.  In addition, the supraspinatus and rotator cuff will slow down the arm at the end of a throwing motion, which is why it is commonly injured in athletes who throw a ball overhand repeatedly, most notably baseball pitchers.  Another common source of injury is a fall on the shoulder, which forcefully stretches the rotator cuff. 

So if you happen to be a baseball pitcher, or you’ve taken a fall on your shoulder and have a rotator cuff problem, you can probably understand why - a trauma or repeated stress damages the muscle and tendon.  But many people who are decidedly NOT athletes develop rotator cuff problems for no apparent reason. 

Unfortunately, the lack of direct trauma or repeated stress to the rotator cuff seems to go unnoticed by many doctors and physical therapists who proceed with treatment without giving any thought as to why someone with no apparent cause developed a rotator cuff injury.  Most of the time, doctors and therapists are content with the diagnosis of a “torn” rotator cuff and treat these patients the same way as they would a person who had suffered trauma or repeated stress to the muscle.  In most of these cases, if doctors would look a little more closely at the MRI findings in such cases, they’d see that rather than being “torn” (which to me implies a single or perhaps a few focal areas of tissue damage) the rotator cuff tendon is actually “frayed” (think in terms of what happens to a rope that has been repeatedly rubbed across a rock). 

I can tell you that in most cases if you treat a frayed rotator cuff the same way you treat a torn rotator cuff, the patient is in for a very long, and usually incomplete recovery because…the shoulder is not the problem!

Wait a minute!  How can the shoulder NOT be the problem in a rotator cuff injury? 

That will be the subject of upcoming posts.  Stay tuned to the Natural Remedies Blog for more information on Rotator Cuff.

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