Rotator cuff
The shoulder is a remarkable joint that allows us to perform a multitude of movements in our daily lives. When the rotator cuff is damaged, this entire freedom of movement is compromised. This condition, which affects the stabilizing tendons of the shoulder, affects many people and often manifests as pain that disrupts sleep and limits activity.
Causes
Rotator cuff injuries result primarily from two mechanisms. The first involves repeated stress on the shoulder, particularly during overhanging movements that create progressive microtraumas on the tendons. The second mechanism is related to the natural aging of the tendon structures, which gradually lose their elasticity and strength. Individual anatomical morphology also plays an important role: some people have an acromion with a bony beak that promotes subacromial impingement and premature wear of the supraspinatus tendon. This wear can progress from simple inflammation to complete rupture of one or more tendons.
Symptoms
Pain is the main symptom of rotator cuff injuries. It typically occurs during activities requiring arm lifting, particularly in an overhanging position, and frequently disrupts nighttime sleep. This pain is gradually accompanied by muscle weakness that makes it difficult to raise the arm and limits range of motion. The supraspinatus tendon, located at the top of the humerus, is most often affected and responsible for this symptomatology. In advanced cases, when several tendons are affected, pseudo-paralysis of the shoulder may develop, making some simple everyday movements impossible.
Treatments
Therapeutic management of the rotator cuff is tailored to the severity of the injury and its functional impact. Conservative treatment is often the first approach, with a physiotherapy program aimed at recentering the head of the humerus in the glenoid cavity and strengthening the compensatory muscles. This rehabilitation helps restore the biomechanical balance of the shoulder and relieve subacromial impingement. Local application of cold and occasional use of anti-inflammatory drugs can complement this approach. In some specific cases, corticosteroid infiltration into the subacromial bursa can reduce inflammation and facilitate rehabilitation. This conservative approach produces good results, particularly for tendonitis and partial tears.
Surgery
Surgery is considered when conservative treatment does not provide sufficient pain relief or in the event of a complete tendon rupture, particularly if it is of traumatic origin. Arthroscopy allows for a precise assessment of the lesions and for repair to be carried out using minimally invasive techniques. The principle consists of suturing and reinserting the ruptured tendon at its bony attachment point at the humeral head. In chronic injuries, the tendon may be retracted and require prior release to allow for tension-free repair. The quality of the muscle and tendon largely determines the prognosis: recent injuries of accidental origin offer excellent results, while long-standing degenerative injuries require individualized assessment. Progressive and appropriate postoperative rehabilitation is an essential step in regaining optimal shoulder function.
Want to learn more about the rotator cuff?
On our Medicol website you will find additional detailed information.
This article is original and was created entirely by our team of referring physicians. Last updated September 17, 2025.
We work in close collaboration
We collaborate with referring physicians, external specialists recognized for their expertise in a specific area of orthopedics. These physicians work in close coordination with us to ensure the best possible care.
Français 
English (UK)