The rotator cuff is a group of 4 muscles that support the shoulder; supraspinatus, infraspinatus, teres minor and subscapularis. The shoulder is the most mobile joint in our body and the rotator cuff provides the dynamic control and stability in the joint during movement.
Like other muscles in the body, the rotator cuff can be injured by overuse or in traumatic shoulder injuries. Parts or sections can be torn (muscle fiber disruption and or seperation), and you can also develop tendinopathy within one of the components of the muscle group (the most common is a supraspinatus tendinopathy). A rotator cuff tear or tendinopathy can cause catching pain when lifting your arm, weakness or aching in the top of the shoulder and arm. This can significantly impair quality of life, and reduce participation in work and recreation/sport.
As we age, our muscles and bones have a natural process of deterioration. The group of muscles that make up the rotator cuff, have an interesting characteristic, in that, occasionally people have a tear in their rotator cuff that is spontaneous (no injury or mechanism other than age/deterioration). Spontaneous tears can present without pain or reduced mobility and function, so it is an important thing to remember when having an ultrasound or MRI for example.
Tears in the rotator cuff do not always require surgery. They can be treated conservatively with exercise and soft tissue treatment. The treatment approach depends on multiple factors relevant to the individual including tear size and mechanism, age and occupation.
Tendinopathy requires an individual assessment to determine what is harmful and what is beneficial to the muscle group. Almost certainly there will be a requirement to engage in a strength/conditioning program (as directed by your treating practitioner) to optimise function and reduce irritation within the muscle group.