Your rotator cuff consists of muscles and tendons that hold your shoulder in place. It allows you to raise your arms and reach upward.
Rotator Cuff Injuries
Rotator cuff problems and tears are common among adults, and are a frequent source of pain and disability.
A rotator cuff injury such as a tear may happen suddenly when falling on an outstretched hand or may develop over time due to repetitive activities. Rotator cuff tears may also happen due to aging, with degeneration of the tissues.
Common symptoms of a rotator cuff tear may include:
- Recurrent pain, especially with certain activities
- Pain that prevents you from sleeping on your injured side
- Grating or cracking sounds when moving your arm
- Limited ability to move your arm
- Muscle weakness
A rotator cuff may tear partially or fully. Partial-thickness tears do not completely sever the tendon from the shoulder.
In addition to a complete medical history and physical exam, diagnostic procedures for a rotator cuff injury may include the following:
- X-ray, which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
Magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
Our orthopaedic specialists will work with you to determine the right treatment for your rotator cuff injury. Treatments may include:
- Nonsteroidal anti-inflammatory medicines
- Strengthening and stretching exercises
- Ultrasound therapy
- Corticosteroid injection
- Surgery (for severe injuries)
Rotator Cuff Surgery
Rotator cuff repair is surgery to fix a severely torn rotator cuff, which is the group of muscles and tendons that hold the bones of the shoulder in place and help in movement of the arm, such as raising the arms overhead. An injury to the rotator cuff may happen suddenly when falling on an outstretched hand, develop over time due to repetitive activities, or simply a result of aging. The goal of the surgery is to help restore the function and flexibility of the shoulder and to relieve the pain that cannot be controlled by other treatments.
Understanding the procedure
At Cooper Bone and Joint Institute, our orthopedic surgeons perform rotator cuff repair traditionally or by using what is considered a minimally-invasive technique. The main difference between the two procedures is the size of the incision. The type of surgery performed often depends on the size, shape, and location of the tear.
The traditional open rotator cuff surgery is done with a large incision (cut) over the shoulder to expose the injury. The surgeon will clean out any inflamed or damaged tissue, and remove any extra bone growth that occurs on normal bone (bone spur), if necessary. The torn tendon, the part of the muscle that attaches it to a bone, is repaired and reattached and/or anchored with stitches or staples that dissolve over time and do not need to be removed. This method is often required if the tear is large or complex or if additional reconstruction, such as a tendon transfer, has to be done.
The minimally invasive arthroscopic approach requires several small incisions on the shoulder. One cut is for a small video camera that transmits images of inside the joint to a monitor in the operating room and helps the surgeon identify the problem. The other cuts are used by the surgeon for other small instruments to repair the tendon. The same procedure is performed through these small cuts as with the open procedure. However, a person will usually have less pain, minimal scarring, and a faster recover when compared with the traditional procedure.
General anesthesia is needed for both surgeries, so the person is asleep during the procedure. They are usually done on an outpatient basis, so the person can go home the same day. In some cases, it may be necessary to stay in the hospital for one or two days.
Indications for the procedure
Surgical repair is generally recommended when the injury is severe or when the rotator cuff tear does not respond to more conservative treatments, such as rest, slinging, and physical therapy, and is associated with significant weakness, loss of function, and limited motion.