S.I.T.S yourself down and learn about the Rotator Cuff!

My outpatient rotation is starting off swimmingly…and that isn’t just because our facility has a sweet therapy pool (ha! ok, ok sorry I’m a little tired still from the adjustment to my new home and clinic life).

Sometimes (serendipitously) patients seem to cluster themselves. In my first few days I have seen several Rotator Cuff Repairs so I’ve been researching and reading about the best evidence based treatment for this condition. Before we get there though, lets talk a little about what the Rotator Cuff is.

BLAM! Take a gander at this.

Simply, the Rotator Cuff is comprised of four muscles that originate on the scapula (shoulder blade) and insert on the humerus (upper arm bone) – they form a muscular-tendonous cuff around the glenohumeral joint (shoulder) that help stabilize the joint and move the arm.

shoulderblade

Spell check alert! That should read Lesser Tuberosity NOT tubercle … same down below (oops)

In medical world we like pneumonics to help learn our anatomy, so for the rotator cuff we talk about “SITS” which is the order from top to bottom that they attach on the humerus.

010814

S – Suprapinatus m. ( “supra” or above the “spinatus” ie spine of the scapula)

I – Infraspinatus m. (“infra” or below the “spine” of the scapula)

T – Teres Minor m.

S – Subscapularis m. (only one to attach on the lesser tuberosity)

 

Who is over eager and wants ALL the info on these bad boys? Keep on reading… (fellow SPTs studying for the boards, cover the answers and see how much you remember from class last year)

Muscle Origin on Scapula Attachment on Humerus Function Innervation
Supraspinatus muscle Suprapinous fossa superior and middle facet of the greater tuberosity Abducts the arm (brings it out to the side) Suprascapular nerve (C5)

 

Infraspinatus muscle Infraspinous fossa Posterior facet of the greater tuberosity externally rotates the arm Suprascapular nerve (C5-C6)
Teres minor muscle middle half of lateral border inferior facet of the greater tuberosity externally rotates the arm Axillary nerve (C5)
Subscapularis muscle subscapular fossa lesser tuberosity (60%) or humeral neck (40%) internally rotates the humerus Upper and Lower subscapular nerve (C5-C6)

 

Interested in learning more? Visit the American Physical Therapy Association’s page on Rotator Cuff Tears for most current and best evident for treatment of this condition, including great free to access scholarly articles:

A Physical Therapist’s Guide to Rotator Cuff Tears

 

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