Rotator cuff Anatomy : Origins and insertions, Functions and Clinical aspects

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Rotator cuff Anatomy : Origins and insertions, Functions and Clinical aspects

The Rotator Cuff (RC) is a common name for the group of 4 distinct muscles and their tendons, which provide strength and stability during motion to the shoulder complex. They are also referred to as the SITS muscle, with reference to the first letter of their names (Supraspinatus, Infraspinatus,Teres minor, and Subscapularis, respectively). The muscles arise from the scapula and connect to the head of the humerus, forming a cuff around the glenohumeral (GH) joint.

Function
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The RC muscles are each used in a variety of upper extremity movements including flexion, abduction, internal rotation and external rotation. They are essential players in almost every type of shoulder movement. Balanced strength and flexibility in each of the four muscles are vital to maintain functioning of the entire shoulder girdle.

As a group, the rotator cuff muscles are responsible for stabilizing the shoulder joint, by providing the "fine tuning" movements of the head of the humerus within the glenoid fossa. They are deeper muscles and are very active in the neuromuscular control of the shoulder complex during upper extremity movements.

They keep the head of the humerus within the small glenoid fossa of the scapula in order to enlarge the range of motion in the GH joint and avoid mechanical obstruction (i.e. a possible biomechanical impingement during elevation).

It is well documented that RC dysfunctions can lead to shoulder pain, impaired functional capacities and a reduced quality of life.

Common Injuries to the Rotator Cuff
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RC injuries are common injuries that can occur at any age. In younger subjects, most injuries occur secondary to trauma or arise from overuse due to overhead activities (e.g. volleyball, tennis, pitching). The incidence of injuries increases with age, however, some individuals with rotator cuff pathology may be asymptomatic. The RC muscles can fall victim to muscle degeneration, impingement, and tearing with advancements in age. Poor biomechanics, such as postural dysfunctions (anterior posture of the GH in the glenoid cavity, for example) can prematurely affect the quality of the RC muscles and tendons due to repetitive strains and tissue encroachment.

Most common injuries to the Rotator Cuff are often referred to as:

Rotator Cuff Tears (micro or macro tearing of the muscles or tendons);
Rotator Cuff Tendinitis (acute inflammation of the RC soft tissue);
Rotator Cuff Tendinopathy (chronic irritation or degeneration of the RC soft tissue);
Impingement syndrome (biomechanical dysfunction of the shoulder complex with causes abnormal wear and tear on the RC soft tissue).

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