How To Move Without Pain

No one has a rotary cup, but we do have a
Rotator Cuff

by Meghan Griech, PT, DPT, cert MDT, CKTP

This article takes 6 minutes to read

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I hear it every day in the clinic and it always makes me chuckle. But I’m here to let you know – you don’t have a rotary cup. We have a rotator cuff and it’s pretty important.

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The rotator cuff is a set of 4 muscles that are attached around the shoulder blade and reach to the top of your arm bone (the humeral head). These muscles have individual jobs and also work together to control how the arm moves and the stability of the shoulder. These muscles have to work together or the mechanics between the arm and shoulder will be off.  If these muscles are not working correctly, it may lead to pain, inflammation or breakdown known as tendinopathy, and even tears within the tendons that could lead to surgery or chronic pain.

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The Rotator Cuff Muscles: 

The shoulder is a ball and socket joint.  The ball (humeral head) can move in the socket (glenoid) through the coordinated actions of the rotator cuff muscles.  The 4 muscles that make up the rotator cuff are the Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. Each with its own action and role during shoulder movement.  

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Supraspinatus: holds the ball in the socket and initiates abducting the arm (reaching out to the side)

Infraspinatus: external rotator of the shoulder – like the hitch hiking movement

Teres Minor:  works together with the posterior deltoid to externally (laterally) rotate the arm (as above), as well as adducts the arm (arm towards your body).

Subscapularis: rotates the arm medially (internal rotation)  – like trying to reach behind your back to tuck your shirt in and adducts the arm.

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Although these muscles all have individual actions, perhaps even more importantly is what they do together.  Since the shoulder is a ball and socket type joint, in order to keep this joint working smoothly, these muscles need to all work together to keep the ball firmly in the socket.  This ensures that other larger shoulder muscles (like the deltoids) can lift the arm up overhead.

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Rotator Cuff Injury Symptoms

The pain associated with a rotator cuff injury may include: 

  • A dull ache deep in the shoulder – usually in the front or front and side of the shoulder
  • Difficulty sleeping or finding a comfortable position to sleep
  • Make it difficult to comb your hair  (Tere minor/Infraspinatus) or reach behind your back (subscapularis)
  • Be accompanied by arm weakness, especially trying to reach overhead (supraspinatus)

All of these are common symptoms, and if you are experiencing any of them, a physical therapist can easily determine where your shoulder pain is coming from. #PTFirst

Even if a physical therapist determines your clinical presentation has the sign/symptoms of a rotator cuff tear or tendonopathy, that doesn’t mean surgery needs to be your end game. There are many exercises that will strengthen and help to correct the muscle imbalances that are found by the physical therapist.

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*Disclaimer: All information in this article is intended for instruction and informational purposes. The author(s) are not responsible for any harm or injury that may result.  This information is used to supplement not replace any advice you were provided from your doctor or another medical health professional.  No guarantees of specific results are expressly made or implied with this article.

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