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main actions mentioned above, but a proper understanding of their importance must include a focus on glenohumeral stability. The glenohumeral joint has the greatest range of motion of any joint in the body. However, this range of motion sacrifices stability for movement, lacking many larger, restraining ligaments characteristic of other major joints. Consequently, the rotator cuff muscles also play a critical role in joint stability. One of the ways the rotator cuff muscles enhance stability in the joint is by fusing with the ligaments of the glenohumeral joint capsule. The rotator cuff muscles at the distal end blend into the glenohumeral joint capsule before attaching to the humerus. Nowhere else in the body is there such a close functional relationship between the muscles crossing the joint and the binding capsule of the joint. Aiding joint stability by holding the humeral head close into the glenoid fossa requires highly complex muscular control because the shoulder's range of motion is so great. Different muscle recruitment patterns are required at all these different joint positions. The rotator cuff muscles can carry out these crucial coordination patterns because of the exceptionally rich collection of sensory receptors in the glenohumeral region. The richly innervated connective tissues in the region feed critical sensory information to the nervous system to help regulate proper muscular control and function. The necessity for precise sensory control is one of the reasons exercise plays such an essential role in rehabilitating the rotator cuff. Given the crucial nature of these functions, rotator cuff disorders can dramatically impact daily life, limiting functional capacity and causing significant discomfort. Understanding this dynamic is the first step toward offering effective care to those we serve. So, let's look at some of the most common rotator cuff disorders. ROTATOR CUFF DISORDERS Rotator Cuff Tears A rotator cuff tear is a muscle strain affecting one of the rotator cuff muscles. A muscle strain is usually graded as mild, moderate, or severe. Mild rotator cuff tears may have minimal discomfort and heal quickly on their own. Severe tears will often need surgical repair and a highly focused regimen of exercise rehabilitation after the surgery. Of the four rotator cuff muscles, the supraspinatus is strained most often. This is mainly because it is vulnerable to repeated compression damage and fraying under the acromion process of the scapula. It is also under the highest demand in shoulder actions, so supraspinatus tears often result from cumulative loading over time. Supraspinatus tears are either partial or full-thickness tears. In a partial- thickness tear, only a portion of the tendon is damaged, leaving some tissue intact. In contrast, full-thickness tears involve complete separation of the tendon from the humerus. Symptoms include pain, weakness, and limited shoulder mobility, especially during overhead activities. The causes are usually multifactorial, including age-related degeneration, overuse (especially repetitive overhead movements), and acute injury (such as falls or sudden lifting). Over time, these factors can lead to microtears, inf lammation, and eventual tearing of the tendon. Infraspinatus and teres minor tears are the next most frequent. Tears in these muscles usually occur close to the musculotendinous junction, where the two muscles blend together. It is hard to determine which of these muscles is torn, so the condition is referred to as a posterior rotator cuff tear. These tears often result from high force loads when decelerating the arm, like at the end of a throwing motion. Subscapularis tears occur, but are the least common of the four rotator cuff tears. This is mainly because other muscles perform the same actions as the L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 25 Infraspinatus and teres minor. Image courtesy of Complete Anatomy. Subscapularis. Image courtesy of Complete Anatomy. Coracoacromial arch. Image courtesy of Complete Anatomy. 2 3 4 Teres minor Coracoacromial arch Infraspinatus