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A rotator cuff strain is a tear to any of the four rotator cuff muscles in the shoulder and is common in throwing and racket sports. They are so called because their job is to rotate the arm at the shoulder and provide a supportive cuff around the joint. Rotator cuff tears can range from mild to severe.
Torn rotator cuff symptoms will consist of sudden pain in the shoulder sometimes accompanied by a tearing feeling. Symptoms may radiate down into the arm. The patient will often be unable to sleep on the injured shoulder and there may be signs of shoulder impingement where the tendon pinches between the ball and socket of the shoulder joint when moving the arm out over head height.
A rotator cuff tear is usually caused by over stretching or a rapid twisting of the joint. There are four rotator cuff muscles in the shoulder which work together to provide the joint with dynamic stability, helping to control it as it rotates. Because the shoulder joint has a large range of motion and often needs to move at very high speeds such as in throwing sports there is a higher risk of injury to the muscles or tendons (which join muscle to bone). The rotator cuff muscles consist of the supraspinatus, infraspinatus, teres minor and subscapularis muscles. Supraspinatus and Infraspinatus are the most commonly injured rotator cuff muscles particularly in sports which involve a lot of shoulder rotation, for example bowling in cricket, pitching in baseball, swimming and kayaking. The injury is also more common in the older athlete, particularly where long term overuse or degeneration is present. In throwing events it is often the case that injury is caused by the rapid deceleration or stopping of the arm once the throw has been released rather than the acceleration phase of the throw.
Treatment for a rotator cuff tear consists of reducing the initial pain and inflammation, allowing the tissues to heel followed by a full rehabilitation program consisting of mobility, stretching, strengthening and functional shoulder exercises.