Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about rotator cuff tears.

And you can find written notes on this topic at zero tofinals.com slash rotator cuff tears or in the orthopaedic surgery section of the zero definals surgery book.

So let's get straight into it.

Rotator cuff tears refers to injury to the tendons of the rotator cuff muscles.

The tendon may be partially or fully torn.

Tears of the rotator cuff can occur due to an acute injury, for example a fall onto an

outstretched hand, or due to degenerative changes with age.

They may be related to overhead activities such as playing tennis or overhead construction

work.

Let's start by talking about the basic anatomy. The rotator cuff is made of four muscles, each with a specific action at the shoulder,

and you can remember these muscles with the numonic SITS, S-I-T-S.

S for Supraspinatus, which abducts the arm, moving the arm outwards away from the body.

I for infraspinatus, which externally rotates the arm.

T for Teres minor, which also externally rotates the arm.

And S for sub-scapularis, which internally rotates the arm.

Let's talk about the presentation. Rotator cuff tears may present either with an acute onset of

symptoms after an acute injury or with a gradual onset of symptoms. Patients typically present with shoulder pain and weakness

and pain with specific movements that relate to the sight of the tear. For example, pain and

weakness during abduction of the arm with a super sporespinatus tear. Patients may find it difficult to get comfortable at night due to the pain in the shoulder

and this disrupts sleep.

Next let's talk about the investigations.

X-rays will not show soft tissue injuries such as rotator cuff tears.

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