What is the Rotator Cuff?
The rotator cuff is a group of 4 muscles in the shoulder joint including the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles originate in the scapula and attach to the head of the humerus through tendons. The rotator cuff forms a sleeve around the humeral head and glenoid cavity, providing stability to the shoulder joint while enabling a wide range of movements.
Injury to the rotator cuff may occur due to pressure on the rotator cuff from part of the shoulder blade (scapula). It may occur due to repeated use of the arm for overhead activities or while playing sports. A forceful injury such as trauma can cause one or more of these tendons to tear, a condition called rotator cuff tear.
A rotator cuff tear may occur with repeated use of the arm for overhead activities, while playing sports, or from a motor accident.
What are the Symptoms of Rotator Cuff Tears?
A rotator cuff tear causes severe pain, weakness of the arm and crackling sensation on moving the shoulder in certain positions. There may be stiffness, swelling, loss of movement and tenderness in the front of the shoulder.
How is a Rotator Cuff Tear Diagnosed?
Your surgeon diagnoses a rotator cuff tear based on a physical examination and X-rays. A rotator cuff tear is best viewed on magnetic resonance imaging (MRI).
Conservative treatment
The conservative treatment options for rotator cuff tears are:
- Rest
- Injection of a steroid (cortisone) and a local anesthetic in the subacromial space of the affected shoulder to relieve inflammation and pain
- Exercises
Surgery for Rotator Cuff Tears
Surgical Management maybe needed when Do not respond to non-surgical treatment options
Rotator cuff repair is a surgery to repair an injured or torn rotator cuff. It is usually performed arthroscopically on an outpatient basis. An arthroscope, a small, fiber-optic instrument consisting of a lens, light source, and video camera. The camera projects images of the inside of the joint onto a large monitor, allowing your doctor to look for any damage, assess the type of injury and repair it. Large rotator cuff tears may require open surgery.
Postoperative Care and Recovery
After the surgery, the small surgical wounds take a few days to heal and the surgical dressing is replaced by simple Band-Aids. The recovery time depends on the type and extent of problem for which the procedure was performed. Pain medications are prescribed to keep you comfortable. The arm of the affected shoulder is placed in a sling for a short period as recommended by your doctor. Physical therapy is advised to improve shoulder mobility and strength after the surgery.
Risks and Complications
Complications are the same as with any surgery which include infection, bleeding, damage to nearby nerves or blood vessels, or delayed healing after the surgery. In certain cases, stiffness of the shoulder joint may occur after the surgery. It is important to participate actively in your physical therapy to prevent this from occurring.