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Rotator Cuff Tears:
Four muscles make up the rotator cuff (SITS) which control internal and external rotation of the shoulder and abduct the shoulder.
- Supraspinatus
- Infraspinatus
- Teres Minor
- Subscapularis
Tears can be due to acute injuries (falls, heavy lifting, forceful abduction), though the majority (>90%) of rotator cuff tears are chronic in nature and due to subacromial impingement and decreased blood supply to the tendons.
Most patients can be treated with sling immobilization, NSAIDs and referral to sports medicine or orthopaedic surgeons. Elderly patients should be referred quickly as prolonged immobilization can lead to a frozen shoulder.