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What is the rotator cuff, and what does it do?

Things your shoulders do for you might seem minor to you, but they play an essential role in your life. They help you to lift or carry weights, do your daily activities, or participate in your favourite sport. Your body makes it look easy, but deep inside, it’s a complicated process. Rotator cuffs play a pivotal role in that. In addition to protecting your shoulders, it allows you to make the most of your arm and shoulder movements.

The rotator cuff is not a single muscle; it’s a combination of four muscles attached to the shoulder joint. The humerus head fits into your shoulder blade socket, also called the scapula. While your arm is extended outward, the rotator cuff muscles prevent your arm bone from popping out of the socket. 

All four muscles and the tendons attached to them form the rotator cuff, and they are responsible for various aspects of shoulder movement. All these muscles and tendons work together to help stabilize your shoulders.

Each of the four muscles that emerge from the shoulder blade can be remembered using the acronym “SITS”:

  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis


This is the muscle responsible for movements away from your body’s centerline (abduction). The supraspinatus muscle can produce the initial 15° motion. Following that, your trapezius and deltoid muscle groups come into action. This stabilizes your upper arm and holds your humerus in place. It also helps you lift your arm.


It is the primary muscle that allows your arm’s lateral rotation, which is away from your body’s centerline. The muscle is thick and has a triangular shape. This is a layer of muscle behind your shoulder blade that lies deep beneath the skin and near the bone.

Teres minor 

The name itself indicates it’s a small and narrow muscle located back of your shoulder blade just under the infraspinatus muscle. It also aids in your lateral (external) arm rotation.


This muscle is the largest and triangular-shaped muscle that is located under the other three muscles. This is the largest, strongest, and most frequently used rotator cuff muscle. It plays a major role in most of your shoulder motions, particularly in the medial rotation (moves your arm towards your midsection). The subscapularis muscle is attached to the front portion of your upper arm.

Common rotator cuff injuries

Rotator cuff problems are common among people with shoulder pain.

Injury to the rotator cuff can occur suddenly, for example, when you fall on your outstretched arm. However, you could also develop it gradually due to repetitive movements or progressive degeneration as you age.

Rotator cuff injuries can be classified as follows:

Rotator cuff tendinopathy – This is a mild rotator cuff injury that may develop due to overuse, trauma, repetitive movements, age-related degeneration, etc.

Shoulder Impingement – This develops when the upper end of the shoulder bone comes into contact with the bursa and tendon, causing rotator cuff irritation. Subacromial impingement syndrome (SAIS) is one of the common forms of shoulder disorder that causes pain.

Bursitis – The bursa which surrounds the rotator cuff may swell due to fluid accumulation. The swelling irritates the rotator cuff and damages it.

Partially torn rotator cuff tendons – There might be damage to the tendon, but the tissue is not detached from the bone.

Full-thickness tears. There will be complete separation of the tendon from the bone. It usually results from chronic degeneration.

Bone spurs – Typically, they develop from the shoulder bone rubbing against the rotator cuff tendons. An injury to the rotator cuff may not always result from bone spurs. 

Treatment for rotator cuff injury

Depending on the type of damage, you will require different treatments for rotator cuff injuries. However, doctors typically prescribe conservative treatment for rotator cuff injuries.

Nonsurgical treatment for rotator cuff injuries: 

Rest, icing, and elevating the damaged area are the first line of treatment options for mild to moderate rotator cuff damage. Nonsteroidal anti-inflammatory drugs (NSAIDs) and over-the-counter (OTC) medication. Strengthening exercises and stretching are also suggested. 

The conservative treatment for rotator cuff tears is effective enough in 73 to 80% of cases, even in full-thickness tears. It typically takes people four to six months to regain strength and range of motion in their shoulder.

Surgical treatment for rotator cuff tears

Your doctor may recommend surgery if your symptoms persist or worsen. Surgery may also be recommended if you have severe shoulder trauma

Talk to the surgeon and choose the type of surgery that will work best for your injury. Options include:

  • Open surgery
  • Arthroscopic surgery  
  • MINI-open surgery 

The recovery time after surgery varies according to the severity of the trauma and the procedure type. Most people recover within months after surgery, but in some cases, recovery may take as long as a year or more. For more detailed information, call +91 99595 88389 and book an appointment to talk to the leading shoulder surgeon in Hyderabad, Dr Chandra Sekhar, MBBS, MS ORTHOPEDICS.

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