The rotator cuff is comprised of four muscles which have tendons that cover the head of the upper arm bone (humerus). It is responsible for movement and strength of the shoulder joint, as well as stabilizing the arm in the joint socket.


The rotator cuff functions in the rotation of the shoulder and lifting of the arm. When the tendon becomes irritated or inflamed this is commonly known as rotator cuff tendonitis. Some patients have calcium deposits in their rotator cuff which makes the rotator cuff susceptible to becoming inflamed. When tendinitis happens in this setting, it is called calcific tendinitis. 

Symptoms of calcific tendonitis include pain, stiffness and/or weakness of the shoulder. Pain will often be felt in the front or side of the shoulder and can radiate down the arm or up towards the neck. Losing strength or motion in the arm can create difficulty in basic daily activities. It can also be extremely painful at night when lying in bed.

Due to the shoulder’s extensive use and flexibility, it is one of the most susceptible joints to injury. When scar tissue forms in the shoulder joint, there is little room for movement, causing a condition known as a frozen shoulder or adhesive capsulitis. Frozen shoulder is more common in when patient have experienced previous inflammatory conditions or have diabetes. The risk of developing this condition increases when recovering from any condition or procedure that prevents moving the arm.


There are three stages of frozen shoulder. The first, known as “freezing”, is normally the most painful and the shoulder loses the most range of motion during this state. Second stage is “frozen,” where the symptoms actually improve but the joint remains stiff, making daily routines difficult. The third stage is “thawing”, where motion progressively improves and the shoulder joint returns to normal strength. 
Symptoms of frozen shoulder include pain develops, difficulty in lifting the arm above the head, or extending the arm straight forward and around the back. 

The labrum is a disc of thickened cartilaginous tissue that helps to support and stabilize the shoulder joint. It is located in the area around the shoulder where the ligaments and biceps tendons attach to support the ball and socket joint. The labrum also provides stability to the shoulder by increasing the contact area.


Labral tears occur when the rim of cartilage, that both lines and reinforces the cof the shoulder, is torn. The labrum can tear with repetitive stress from overhead activities such as throwing or after partial or complete shoulder dislocations.

The two most common types of injuries to the labrum are superior labrum anterior posterior (SLAP) tears and anterior labrum (Bankart) tears. SLAP tears occur on the superior portion or top of the labrum where the bicep tendon attaches. Athletes that participate in overhead sports are at increased risk for SLAP tears. Bankart tears typically occur when the head of the humorous shifts forward causing anterior tearing and subsequent instability. Labral tears can also occur in the posterior aspect of the shoulder as a result of repetitive stress or a posterior or backward directed force to the shoulder causing posterior instability.

Little Leaguer’s shoulder and elbow refer to pain syndromes in the growing child who participates in overhead throwing sports (primarily baseball).


Overhead throwing places excessive stress on the growth plates of the shoulder and/or elbow due to the repetitive motion of throwing. Preventive measures can be taken by performing pre-season warm-ups.

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