The rotator cuff is the "guardian of the shoulder" and is a complex of four muscles that arise from the shoulder blade before inserting on the ball of the shoulder. These four muscles or tendons ( a muscle becomes a tendon before it inserts onto the bone) are the Supraspinatus, the Infraspinatus, the Subscapularis and the Teres Minor .
These "cuff" muscles serve to stabilise the ball in the socket and initiate a variety of movements at the shoulder joint.
They can be abraded (see Impingement) and torn, and are the cause of much pathology around the shoulder.
Rotator cuff tears are diagnosed on the basis of history and clinical examination. They can be confirmed by ultrasound or MRI scans.
In younger patients full thickness traumatic tears of the cuff are likely to require operative repair (either open or arthroscopically). Older patients and bigger tears are judged on their merits and symptoms.
Rotator cuff tears usually present with pain and weakness of the shoulder in the higher arcs of movement.