The Aging Shoulder

Written by: Dr. Michael Sabatino PT, DPT

The rotator cuff is a group of tendons and muscles in the shoulder, connecting the upper arm (humerus) to the shoulder blade (scapula). The rotator cuff tendons provide stability to the shoulder; the muscles allow the shoulder to rotate. Each muscle of the rotator cuff inserts at the scapula, and has a tendon that attaches to the humerus. Together, the tendons and other tissues form a cuff around the humerus. Over time we can wear these tendons out causing sprains, strains, tendonitis or even tears.

Depending on the extent of the injury to the shoulder there are various exercises can improve flexibility and strength of the other muscles in the rotator cuff. This increased strength can help compensate for a rotator cuff problem.

The shoulder joint is considered a ‘ball and socket’ joint, however, the ‘socket’ (the glenoid fossa of the scapula) is quite shallow and small, covering at most only a third of the ‘ball’ (the head of the humerus). The socket is deepened by the glenoid labrum. However sometimes there is more involvement than just the rotator cuff. The glenoid labrum is similar to the meniscus of the knee. It is a fibro-cartilaginous rubbery structure which encircles the glenoid cavity deepening the socket providing static stability to the glenohumeral joint. It acts and looks almost like a washer, sealing the two sides of the joint together.

Sometimes these matters can be managed by conservative therapy, however there are times where diagnostic imaging and an orthopedist may be required to remedy the issues with your shoulder. Everyone heals at different rates and respond differently to different approaches, speaking to your doctor or therapist will help dictate the best course of treatment.