Rotator cuff injuries in overhead athletes

Sporting activities, such as throwing, swimming, tennis, and the javelin, require the shoulder to rotate at high speeds with the arm abducted, which places the rotator cuff at risk for microtraumatic injury. The rotator cuff works with the labrum and glenohumeral ligaments to restrain abnormal motion of the humeral head on the glenoid. If microtraumatic injury occurs to one component of this restraint system, greater forces are placed on the other components, often resulting in combined injuries, for example to the rotator cuff and labrum. The clinician should be aware that combined injuries are common, and it is difficult to isolate an injury to a single structure by using history, physical examination, or imaging.