Anatomy-Lexicon

Rotator cuff

Figure shoulder joint
Figure shoulder

Synonyms in a broader sense

Supraspinatus tendon
Shoulder muscles
Supraspinatus muscle
Infraspinatus muscle
Teres minor muscle

English: rotator cuff

anatomy

As Rotator cuff denotes a functionally important muscle group shoulderthat on shoulder blade (Scapula) has its origin and is like a cuff around the Humerus head and is jointly responsible for the rotation and lifting of the arm.

One differentiates between the rotator cuff

Subscapularis muscle
Supraspinatus muscle
Infraspinatus muscle
Teres minor muscle

Of the Subscapularis muscle (Latin "sub": under, "scapula": shoulder blade) arises from the front of the Shoulder blade in the subscapular fossa and attaches to the front of the humerus at the lesser tuberosity. Functionally, it serves to turn the arm inwards (internal rotation), it is even the strongest internal rotator on the upper arm. It also supports the movement of the arm forwards (anteversion) and backwards (retroversion). Like all rotator cuff muscles, it also contributes to the tension in the joint capsule. It is innervated by the Subscapular nerve.

Of the Supraspinatus muscle (Latin "supra": above, "spina": thorn) arises on the upper part of the back surface of the shoulder blade in the supraspinous fossa and runs under the Shoulder roof through to Greater tuberosity on the humerus. Its function is that of side arm lift (Abduction), especially in the starting phase of the movement up to approx. 15 ° abduction, he is the "Abduction starterIt shares this function with the deltoid muscle. It also has less of an effect on the external rotation of the arm and also tensions the joint capsule Suprascapular nerve innervates.

He knows about all the rotator cuff muscles most common injury especially since his tendon often becomes calcified with age. These calcium deposits can lead to a so-called Impingement Syndrome lead: This clinical picture involves pinching or pinching the tendon of the supraspinatus muscle under the roof of the shoulder. This results Pain when lifting the arm to the side or during stress, such as when lying on the affected arm.

Figure shoulder joint

Collarbone
Shoulder roof (acromion)
Space between the humerus head and the shoulder roof
Humerus
Shoulder joint (articulatio glenohumerale)

This is another clinical picture Suprascapularis Syndrome dar: In this case the Suprascapular nerve, which supplies both the supraspinatus and infraspinatus muscles, is trapped in a notch in the shoulder blade and it occurs Pain in the shoulder and a weakening of the external rotation and abduction.

Of the Infraspinatus muscle (lat. "infra": below, "spina": sting) arises on the lower part of the back surface of the shoulder blade, the so-called. Infraspinate fossa, and also moves to Greater tuberosity of the humeral head, slightly behind the supraspinatus muscle. If you look at the course of the muscle - from the shoulder blade to the lateral head of the upper arm - you can easily understand its function: When the infraspinatus muscle contracts, it causes a powerful outward rotation of the arm (external rotation), it is even that strongest external rotator of the upper arm. In addition to the external rotation, he is also on Draw on of the upper arm to the middle of the body (adduction). When the arm is raised, however, it causes the arm to be guided away from the center of the body. Together with the other muscles of the rotator cuff, it tightens the capsule around the shoulder joint. The innervation takes place over the Suprascapular nerve.

Of the Teres minor muscle (lat "minor": smaller, "teres": round) has its origin at the side edge of the shoulder blade below the infraspinatus muscle. It also pulls towards the greater tuberosity on the humerus. Functionally it is a weak one Outside turner (External rotation) of the upper arm. It also helps to pull the upper arm towards the body (adduction). The M. teres minor and the M. infraspinatus thus not only form an anatomical but also a functional unit. However, both muscles differ in their innervation: The M. teres minor is from the Axillary nerve innervated.

Function of the rotator cuff

The function for the arm movement of everyone at the Rotator cuff involved muscle has already been described.
In summary, the rotator cuff plays an important role in the rotation of the arm, i.e. in the external and internal rotation of the upper arm.
The Rotator cuff is therefore extremely important for the mobility of the whole arm. Along with other muscles, the rotator cuff gives that Shoulder joint the greatest freedom of movement of all Joints of man.

In addition, each muscle of the rotator cuff tensions the joint capsule of the shoulder joint and thus gives the shoulder joint stability.

Because of the small bony guidance of the shoulder joint and the weak ligamentous apparatus, the shoulder joint is secured primarily by the rotator cuff and the deltoid muscle (Deltoid) accepted. Together they cause the humerus head to be held (centered) in the joint socket.
However, this also explains the high loads that are placed on the Rotator cuff act and the consequences of injuries that result from it.

Appointment with a shoulder specialist

I would be happy to advise you!

Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of .

The shoulder joint is one of the most complicated joints in the human body.

The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.

Rotator cuff disorders

Unlike other large joints in the body, this will Shoulder joint mainly guided and stabilized by its soft tissues (muscles, ligaments, joint capsule).
The contact of the large humeral head (humerus) with the shoulder joint socket (glenoid) is only slight. Because of these enormous loads are found Diseases of the shoulder joint accumulated in the area of the rotator cuff.

The is particularly often affected Supraspinatus muscle which pulls under the shoulder roof to the humerus head. When the arm moves over the horizontal, this muscle becomes too tight because the head of the humerus rises under the canopy when the arm is raised. Constitutional or wear-related acquired shoulder roof tightness can lead to the clinical picture of Impingement Syndrome come. This means the repeated pinching of the Supraspinatus tendon under the roof of the shoulders, causing inflammation of the tendon and that located there Bursa (Subacromial bursitis). If the load-bearing capacity of the supraspinatus tendon is exceeded, it can tear without adequate injury (supraspinatus tendon rupture / Rotator cuff tear).
The German translation of Impingementyndrom means bottleneck syndrome, which is also synonymous with shoulder bottleneck syndrome.

Chronic damage can also result Lime in the supraspinatus tendon deposit, but also in other rotator cuff tendons.
One speaks then of the clinical picture of a tendinitis calcarea or Lime shoulder.

Rotator cuff pain

Often times the cause lies in Shoulder pain in the area of the rotator cuff. Most complaints occur during exercise, such as when Spreading the arm and especially when trying to raise the arm completely. Symptoms include Pain under load or when lying on the arm, e.g. at night that even radiate to the hand. Also one Muscle weakness in the shoulder area as well Functional restrictions can be symptoms.

Typically are Tendon changes the cause of these complaints. Changes in bone structure, degenerative changes in tendons, e.g. calcification that increases with age, or trauma can lead to a Entrapment of the supraspinatus tendon to lead. This entrapment is called impingement syndrome and causes pain that occurs when the arm is raised above 60 ° and disappears when the arm is raised above 120 °. This area is also called "Painful arc" called.

This phenomenon is based on the fact that when the arm is raised, the space under the shoulder roof is reduced and the pre-damaged tendon of the supraspinatus muscle that runs underneath is pinched. This phenomenon often occurs Athletes especially with swimmers, tennis, golf and handball players. To confirm the diagnosis, a Imaging (X-ray, MRI) performed. Therapy can be conservative, i.e. with the help of physiotherapy and various medications, as well as surgical arthroscopy.

Inflammation of the rotator cuff

Inflammation is often a reaction the body has to it Injuries and join especially Irritation of muscles or tendons. In the shoulder area, inflammation is often found in the presence of Calcifications observed.

With an inflammation of the rotator cuff classic symptoms can be observed: The shoulder area is in side comparison reddened, often overheated and swollen, movement is often restricted and painful. If symptoms persist or worsen for several days, a doctor should be considered.

With repeated inflammation, calcifications can form, especially in the area of the tendons, and lead to functional restrictions and pain, see Impingement Syndrome. A detailed medical history and physical examination, a blood sample to measure inflammatory parameters, and an imaging test (e.g. MRI) can help to confirm the diagnosis. In any case, the shoulder should be protected and if possible a shoulder orthosis or bandage should be worn. For pain management should be best Non-steroidal anti-inflammatory drugs be considered. Physical therapy and physical therapy can help minimize pain and loss of function.

Rotator cuff tear

The rotator cuff is essential for countless movements that are carried out every day and which are often associated with stress. With increasing age, the tendons wear more and more and the risk of rupture, i.e. the probability of a tear, increases. Furthermore, calcifications and changed bone structures make the tendons even more fragile. However, the tendons very rarely tear on their own, but rather than Result of traumae.g. after a fall. The tendon is particularly at risk M. supraspinatuswhich is exposed to particular stress due to its close anatomical proximity to the shoulder roof (acromion).

With a rotator cuff tear one usually feels sudden severe pain in the whole shoulder area. The pain is often too Dependent on position and movement: When lying on the affected arm or lifting from the arm, the pain becomes more severe. Pain is also typical at night occur and affect the sleep rhythm. A reduction in strength and limited mobility of the shoulder also occur with a rotator cuff tear. An ultrasound or an MRI may be done to help confirm the diagnosis.

To restore the function of the muscle, the The tendon sewn back together become. This is mostly done arthroscopicusing small rods that can be inserted into the shoulder to avoid open surgery.

By the way, should physiotherapy may be prescribed to rebuild the strength of the damaged muscle and to strengthen the other muscles of the rotator cuff.

Rotator cuff training

The training of the shoulder muscles not only has an aesthetic and athletic sense, but is also medically suitable to counteract future damage in the shoulder area. In order to be able to train the rotator cuff effectively, one should take a good look at its functional diversity: external rotation, internal rotation, abduction and adduction.

Attention: Before you start training, you should always stretch your muscles! An exercise band is also required for meaningful exercises. After you have fixed the exercise band at a fixed point at shoulder height, you can train the internal and external rotation by extending your arm to the side, holding your elbow at a 90 ° angle and slowly performing the throwing motion. In order to train the external rotation even more effectively, it is advisable to fasten the exercise band securely to the floor and then, in the position as just described (upper arm stretched out to the side, elbow at a 90 ° angle), turn the upper arm upwards and thus the band to stretch upwards.

The abduction can be trained by holding both arms at the sides of the body, holding the band with each hand, whereby it should be quite tense, and then slowly spreading the straight arms to the side. Sports such as swimming or handball can be good ways to exercise the rotator cuff.

Read more on the subject at: Shoulder muscle training