The term rotator cuff covers several muscles together with their tendons, which extend from the shoulder blade and around the humeral head. On account of this coating, the rotator cuff contributes significantly to ensuring that the humeral head does not pop out of the relatively small joint socket (= dynamic joint stabilization).

The rotator cuff is also involved in the following arm movements: lateral abduction, adduction of the upper arm, and internal and external rotation.

The most frequent cause of damage to the rotator cuff concerns the tendons or their appendages, that themselves are poorly perfused and therefore in the context of the processes of aging are particularly prone to wear.
A further frequent cause is the formation of bony spurs on the acromion, which can lead to mechanical irritation and, with time, to tears in the ligaments.

In contrast, in younger patients, injuries to the rotator cuff are primarily due to sports or work accidents, which in part lead to extensive tearing of the rotator cuff.

Which therapies come into consideration?

Depending on the pattern of injury, physiotherapeutic measures can be justified in the first instance. However, if a satisfactory result cannot be achieved, surgery should be considered not later than after three months.

Consideration can then be given to arthroscopic treatment, which can either be used alone or in combination with so-called minimally-open surgery, namely in a procedure that indeed requires a slightly larger skin incision than arthroscopy, but does not result in a scar such as that which remains following large-scale shoulder surgery. The decision as to which procedure is most suitable in a given case should be made by an experienced shoulder specialist on the basis of the surgical objective (e.g. reattachment of the tendons, excision of spurs, bursectomy).