The Rotator Cuff consists of four separate muscles and their tendons. These muscles are responsible for raising the arm away from the body. The muscles of the rotator cuff are attached to thick tendons which cover the shoulder joint and insert into the head of the humerus. These tendons are the area of the rotator cuff that is subject to tears and damage.
Tears of the rotator cuff are more common among middle aged and older patients. Tears of the rotator cuff may be caused by a traumatic episode that involves abnormal stresses being applied to these tendons, but most rotator cuff tears occur as a slow wearing down of the tendons. This is caused by the direct pressure of the acromion grinding upon the rotator cuff tendons. This repeated pressure upon the tendons is called Shoulder Impingement will eventually wear down the rotator cuff and may produce complete tears of the rotator cuff tendons. Please refer to the Shoulder Impingement page for more on this subject.
The tendons of the rotator cuff may tear in a variety of locations along their surfaces. These tears can range from minor tears, which may only cause mild pain and discomfort, to complete tears which require surgery to repair. Minor tears of the rotator cuff includes those that have not completely penetrated the full thickness of the tendon. These may heal with conservative treatment, although some may lead to complete tears which require surgery to repair. The most severe tears of the rotator cuff may not be surgically repairable at all, but during surgery every possible effort is made to repair the torn tendons of the rotator cuff.