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The rotator cuff provides dynamic stability and is critical to normal shoulder function. Forces generated by the rotator cuff facilitate the motions involved in activities of daily living and the more demanding movements of athletics and manual labor. Injury and pathology of the rotator cuff are common and the unique anatomical and biomechanical characteristics of the cuff contribute to the etiology of its injury. This review provides a biomechanical and anatomic context to understanding normal rotator cuff function and summarizes recent work describing biomechanical implications of cuff pathology.