The outfield footballer’s shoulder almost never appears in injury statistics. The goalkeeper’s shoulder, on the other hand, is one of the most punished anatomical areas in professional sport. Every plank start, every corner clearance and every block demands the rotator cuff, the muscle complex that stabilizes the shoulder and controls much of the arm’s movements, to work in extreme positions and with loads that very few outfield players experience. This exposure makes the complex formed by supraspinatus, infraspinatus, subscapularis and teres minor (the SITS muscles) the most vulnerable link in the goalkeeper’s upper limb. It is worth knowing the functional anatomy of the cuff, the typical injury mechanisms in goalkeepers and other throwing sports in order to establish preventive protocols with the support of scientific evidence. The relevance of the rotator cuff is better understood if one takes into account that the shoulder is the most mobile joint in the human body. This extraordinary freedom of movement allows complex overhead gestures to be performed, the arm to be accelerated at high speed and high forces to be absorbed during falls or impacts. However, that mobility comes at a price: bone stability is limited and depends heavily on soft structures such as muscles, tendons, ligaments, and the glenoid labrum. Among all of them, the rotator cuff plays a central role, as it keeps the head of the humerus centered in the glenoid cavity during movement and prevents displacements that could compromise joint function. When this structure becomes fatigued or injured, not only does the strength of the shoulder decrease, but its mechanical stability is also altered and the risk of more complex injuries increases. Although goalkeepers cover approximately half the distance of an outfield player and have lower overall energy requirements, the mechanical demands derived from repeated jumps, falls, blocks and throws concentrate enormous stress on certain anatomical structures