| Rotator cuff | |
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| Muscles on the dorsum of the scapula, and the Triceps brachii. | |
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| The scapular and circumflex arteries. | |
| Gray's | subject #123 |
The rotator cuff (rotor cuff) is an anatomical term given to the group of muscles and their tendons that act to stabilize the shoulder. Human anatomy, which with physiology and biochemistry is a complementary basic medical science is primarily the scientific study of the morphology of the adult Human body Muscle (from Latin musculus, diminutive of mus "mouse" is contractile tissue of the body and is derived from the A tendon (or sinew) is a tough band of Fibrous connective tissue that usually connects Muscle to Bone and is capable of withstanding tension In Human anatomy, the shoulder joint comprises the part of the body where the Humerus attaches to the Scapula. Along with the teres major and the deltoid the four muscles of the rotator cuff make up the six scapulohumeral (those that connect to the humerus and scapula) muscles of the human body. Teres major is a muscle of the Upper limb and one of six scapulohumeral muscles In Human anatomy, the deltoid muscle is the Muscle forming the rounded contour of the Shoulder. The humerus is a Long bone in the Arm or Forelimb that runs from the Shoulder to the Elbow. In Anatomy, the scapula, omo, or shoulder blade, is the Bone that connects the Humerus (arm bone with the Clavicle (collar The human body is the entire physical and mental structure of a Human Organism.
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Function
These muscles arise from the scapula and connect to the head of the humerus forming a cuff at the shoulder joint. In Anatomy, the scapula, omo, or shoulder blade, is the Bone that connects the Humerus (arm bone with the Clavicle (collar The humerus is a Long bone in the Arm or Forelimb that runs from the Shoulder to the Elbow. They are important because they hold the head of the humerus in the small and shallow glenoid fossa of the scapula. The glenohumeral joint is often likened to a golf ball sitting on a golf tee. The glenohumeral joint, commonly known as the Shoulder joint, is a synovial Ball and socket joint and involves articulation between the A golf ball is a Ball designed to be used in the game of Golf. During elevation of the arm, the rotator cuff compresses the glenohumeral joint in order to allow the large deltoid muscle to further elevate the arm. In Human anatomy, the deltoid muscle is the Muscle forming the rounded contour of the Shoulder. In other words, without the rotator cuff, the humeral head would ride up partially out of the glenoid fossa, lessening the efficiency of the deltoid muscle.
Some anatomists dispute the importance of the rotator cuff. According to them the m. biceps brachii is the key factor in keeping the bones together.
Muscles composing rotator cuff
| Muscle | Origin on scapula | Attachment on humerus | Function | Innervation |
| Supraspinatus muscle | supraspinous fossa | greater tubercle | abducts the arm | Suprascapular nerve (C5) |
| Infraspinatus muscle | infraspinous fossa | greater tubercle | laterally rotates the arm | Suprascapular nerve (C5-C6) |
| Teres minor muscle | lateral border | greater tubercle | laterally rotates the arm | Axillary nerve (C5) |
| Subscapularis muscle | subscapular fossa | lesser tubercle | medially rotates the humerus | Subscapular nerve (C5-C6) |
The mnemonic "SITS" is often used to remember the four muscles of the rotator cuff. The supraspinatus is a relatively small muscle of the upper limb that takes its name from its origin from the Supraspinous fossa superior to the spine of the Scapula The supraspinatous fossa ( supraspinatus fossa, supraspinous fossa) of the Scapula, smaller than the Infraspinatous fossa, is concave smooth The greater tubercle of the Humerus is situated lateral to the head of the humerus and posteriolateral to the Lesser tubercle. Abduction, in functional anatomy is a movement which draws a limb away from the median ( Sagittal) plane of the body In Anatomy, an arm is one of the Upper limbs of an animal The term arm can also be used for analogous structures such as one of the paired upper limbs The Infraspinatus muscle is a thick triangular Muscle, which occupies the chief part of the Infraspinatous fossa. The infraspinatous fossa ( infraspinatus fossa, infraspinous fossa) of the Scapula is much larger than the Supraspinatous fossa; toward its vertebral External rotation (or lateral rotation) is rotation away from the center of the body The Teres minor is a narrow elongated muscle of the Rotator cuff. }The lateral border (or axillary border, or margin) is the thickest of the three borders of the Scapula. The Subscapularis is a large triangular muscle which fills the Subscapular fossa. The costal or ventral surface of the Scapula presents a broad concavity the subscapular fossa. The lesser tubercle of the Humerus, although smaller is more prominent than the Greater tubercle: it is situated in front and is directed medialward and forward In Anatomy, internal rotation (also known as medial rotation) is rotation towards the center of the body The humerus is a Long bone in the Arm or Forelimb that runs from the Shoulder to the Elbow. A mnemonic device (nəˈmɒnɪk is a Memory aid Commonly met mnemonics are often verbal something such as a very short poem or a special word used to help a person remember
Injuries
Rotator cuff tear
This group of tendons can become torn, leading to pain and restricted movement of the arm. Rotator cuff tears are tears of one or more of the four Tendons of the Rotator cuff muscles Rotator cuff tears are tears of one or more of the four Tendons of the Rotator cuff muscles Pain, in the sense of physical pain, is a typical sensory experience that may be described as the unpleasant awareness of a noxious stimulus or bodily harm A torn rotator cuff can occur following a trauma to the shoulder or it can occur through "wear and tear" of the tendons under the acromion. Rotator cuff tears are tears of one or more of the four Tendons of the Rotator cuff muscles The acromion process, or simply the acromion (from Greek akros, "highest" ōmos, "shoulder" is an anatomical feature It is an injury frequently sustained by athletes whose duties involve making repetitive throws, such as baseball pitchers, American football quarterbacks, swimmers, boxers, fast bowlers in cricket and tennis players (due to their service motion). Baseball is a Bat-and-ball Sport played between two teams of nine players each In Baseball, the pitcher is the player who throwsthe baseball from the Pitcher's mound toward the Catcher to begin each play with the goal of American football, known in the United States and Canada simply as football, is a competitive Team sport known for mixing strategy with Quarterback ( QB) is a position in American and Canadian football. Fast bowling, sometimes known as pace bowling, is one of the two main approaches to bowling in the Sport of Cricket. It is commonly associated with motions that require repeated overhead motions or forceful pulling motions.
Rotator cuff impingement
A systematic review of relevant research found that the accuracy of the physical examination is low. A systematic review is a Literature review focused on a single question which tries to identify appraise select and synthesize all high quality research evidence relevant to [1] The Hawkins-Kennedy test[2][3] has a sensitivity of approximately 80% to 90% for detecting impingement. The infraspinatus and supraspinatus[4] tests have a specificity of 80% to 90%. The Infraspinatus muscle is a thick triangular Muscle, which occupies the chief part of the Infraspinatous fossa. The supraspinatus is a relatively small muscle of the upper limb that takes its name from its origin from the Supraspinous fossa superior to the spine of the Scapula [1]
Treatment
Reduce pain and swelling
As with all muscle injuries, R.I.C.E. is the modality recommended by MDs, DOs, Physical Therapists, Athletic Trainers, and Chiropractors. RICE is a treatment method for Soft tissue injury which is an acronym for Rest, Ice, Compression and Elevation.
- Rest means ceasing movement of the affected area.
- Icing uses ice to reduce inflammation.
- Compression limits the swelling.
- Elevation involves placing the area higher to reduce inflammation and swelling.
Cold compression therapy is very useful for all muscle tears and strains as it reduces pain and swelling. Cold Compression Therapy combines two of the principles of RI Using a cold compression therapy wrap for 15 minutes before sleeping can aid in reducing the pain which causes a restless nights sleep.
Strengthening
The rotator cuff can be strengthened to rehabilitate shoulder injuries, and prevent future ones. There are different exercises to target the individual rotator cuff muscles.
| Description | Beginning | End |
| The most effective is the side-lying external rotation, which activates the supraspinatus, subscapularis, infraspinatus and teres minor. The side-lying external rotation involves the person selecting a dumbbell of low weight initially when first training - no more than 3 kilograms. A dumbbell is a piece of equipment used in Weight training, and is a type of free weight. The lifter lies on a bench sideways, with the arm next to his side and slightly flexed at the elbow. The dumbbell should then be raised towards the ceiling to a 45 degree angle, with the arm still flexed and close to the body, at a pace of two seconds up and four seconds down. The side-lying abduction does not involve the teres minor, but moderately involve the deltoid muscles, making it an excellent all-round shoulder exercise. In Human anatomy, the deltoid muscle is the Muscle forming the rounded contour of the Shoulder. |  |
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| Another exercise is the propped external rotator, which targets the infraspinatus and teres minor. The lifter should sit perpendicular to the barbell, with his arm flexed at 90 degrees at the elbow and the forearm resting parallel on the barbell. A barbell is a piece of Exercise equipment used in Weight training, Weightlifting and Powerlifting. Again, selecting a dumbbell of modest weight if just beginning, raise the dumbbell up until the forearm points up. Slowly lower the dumbbell and repeat, exercising both arms. |  |
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| The final exercise is the lateral raise with internal rotation (LRIR). Grasping a dumbbell in each hand, the lifter should internally rotate his arm so that his extended thumbs point towards the floor - as if the lifter is emptying a drink into a bin. The lifter should then raise his arms sideways, with the thumbs still pointing downwards, until the dumbbells are just below the shoulders. The LRIR primarily targets the supraspinatus. |  |
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Strengthening the rotator cuff allows for increased loads in a variety of exercises. When weightlifters are unable to increase the weight they can lift on a pushing exercise (such as the bench press or military press) for an extended period of time, strengthening the rotator cuff can often allow them to begin making gains again. Weightlifting, also called Olympic weightlifting or Olympic-style weightlifting, is a sport in which participants attempt a maximum weight single lift of a barbell The bench press is a Strength training exercise in which while lying on his back the person performing the bench press lowers a weight to the level of the chest then The military press is a variation of the Overhead press Weight training exercise It also prevents future injuries to the glenohumeral joint, balancing the often-dominant internal rotators with stronger external rotators. Finally, exercising the rotator cuff can lead to improved posture, as without exercise to the external rotator, the internal rotators can see a shortening, leading to tightness. External rotation (or lateral rotation) is rotation away from the center of the body This often manifests itself as rounded shoulders in the population.
Surgery
When the rotator cuff is torn, surgery is usually required to reattach the tendon to the bone. [1]
Additional images
 Diagram of the human shoulder joint |
 Suprascapular and axillary nerves of right side, seen from behind. |
 The suprascapular, axillary, and radial nerves. |
References
- ^ a b Hegedus EJ, Goode A, Campbell S, et al (2007). "Physical Examination Tests of the Shoulder: A Systematic Review with Meta-analysis of Individual Tests": 80. doi:. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 17720798.
- ^ ShoulderDoc. co. uk Shoulder and Elbow Surgery. Hawkins-Kennedy Test. Retrieved on 2007-09-12. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1213 - Albigensian Crusade: Simon de Montfort 5th Earl of Leicester, defeats Peter II of Aragon at the (video)
- ^ Brukner P, Khan K, Kibler WB. Chapter 14: Shoulder Pain. Retrieved on 2007-08-30. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1363 - Beginning date of the Battle of Lake Poyang; the forces of two Chinese rebel leaders— Chen Youliang and
- ^ ShoulderDoc. co. uk Shoulder and Elbow Surgery. Empty Can/Full Can Test. Retrieved on 2007-09-12. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1213 - Albigensian Crusade: Simon de Montfort 5th Earl of Leicester, defeats Peter II of Aragon at the (video)
External links
- Free weight training gets workers with rotator cuff injuries back on the job Federation of American Societies for Experimental Biology
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