Rotator Cuff Tear

In depth

When the shoulder rotator cuff is torn, the affected limb becomes painful and weak. Nearly 2 million Americans seek medical care for rotator cuff tears each year, according to the American Academy of Orthopedic Surgeons.

One of the most common causes of pain and disability in adults is rotator cuff tears. Almost 2 million Americans seek treatment for rotator cuff problems every year. Shoulder weakness can result from a torn rotator cuff. You may find it painful and difficult to perform many daily tasks, such as combing your hair or putting on clothes.

What Is a Rotator Cuff Tear?

In order for your arm to be in your shoulder socket, it needs to be secured by the rotator cuff. An arm’s humerus bone is attached to the shoulder blade by a group of muscles and tendons. Furthermore, the rotator cuff has a bursa, which facilitates tendons’ movement. You can rotate your arm by using the rotator cuff if it works properly.

What Causes a Rotator Cuff Tear?

At least one rotator cuff tendon tears away from the top of the humerus during a rotator cuff tear. When your arm is outstretched, you could tear it if you fall onto it or if you lift a heavy weight with a sudden motion. It is possible to fracture your collarbone and dislocate your shoulder simultaneously.

As part of the aging process, rotator cuff tears are commonly caused by natural degeneration. Due to a decline in blood supply to your rotator cuff, your body’s ability to repair damage to it diminishes as you age. A condition known as shoulder impingement can also develop as a result of bone spurs that rub against the rotator cuff.

In addition, repetitive shoulder movements over a long period of time are particularly likely to lead to degenerative rotator cuff tears:

Positions involving repetitive movements, such as professional decorating, are also prone to injuries.

How Are Rotator Cuff Tears Treated?

Untreated rotator cuff injuries can make your shoulder worse over time, so coming in for treatment is crucial if you are experiencing pain or weakness in your shoulder.

You’ll receive the proper diagnosis and assessment of your rotator cuff injury. Among the possible treatments are:

• Using non-steroidal anti-inflammatory drugs (NSAIDs)
• Resting the affected shoulder
• Avoiding activities that cause pain

Most rotator cuff tears can be treated conservatively, but if the injury is severe, or if surgery is necessary, then surgery might be your best choice.

What to expect in surgery?

Rotator cuff surgery should be properly explained to any patient who considers or undergoes it. There are several surgical techniques that can be used to repair a torn rotator cuff depending on the severity of the tear, the surgeon’s experience, and the quality of the surrounding tissue. No matter what the technique, anesthesia is required. General anesthesia is generally combined with peripheral nerve blocks and local anesthetic injections.

Rotator cuff surgery can eliminate the symptoms someone is experiencing, mainly shoulder pain , shoulder weakness, or both when nonsurgical treatments haven’t worked. When the tears are large, surgical intervention may be necessary. Rotator cuff surgery does have some limitations, however. In some cases, nonsurgical treatment may be more effective than surgery. Therefore, surgical treatment is often sought as a last resort.

A structured physical examination and a careful history will confirm whether you have a rotator cuff tear. As part of the physical examination, checking and palpating should be done, along with range of motion and strength examinations. Clinicians should assess passive and active range of motion at 0° and 90°: forward flexion, abduction, and internal/external rotation. While rotator cuff tears cause active range of motion to be restricted, passive range of motion can often be preserved. Hand-held dynamometers are available for testing strength. Different muscles exert different forces during different motions. Testing the subscapularis muscle, supraspinatus muscle, and infraspinatus muscle involve external rotation and abduction. Shoulder weakness is commonly associated with rotator cuff tears. When the examiner determines that the patient successfully completed the task by using other muscles, the muscle performance measurement must be discounted. Rotator cuff examinations require a number of specific tests. This article presents some of them. When one test indicates the respective tendon is torn, the respective tendon is torn. An adverse result occurs when there is a deficit in performance or maintaining the position.

What is the outlook for a rotator cuff injury?

Rotator cuff injuries have varying prognosis based on their types. As the Mayo Clinic reports, half of the people who sustain rotator cuff injuries recover from their injuries at home. Pain is reduced and movement is improved through such interventions.

The strength of the shoulder may not improve if the rotator cuff is damaged severely and has to be surgically corrected.

How can a rotator cuff injury be prevented?

Ice can help reduce swelling in the shoulder area when it is experiencing pain. You should only apply ice for ten minutes at a time in a cloth-covered pack. Performing these exercises can reduce the likelihood of re-injury.

A severe tear of the rotator cuff may require surgery. If you are an athlete or use your arms and shoulders for work a lot, or if your pain does not improve with medical treatment and rest, you may need surgery. Surgical options include conventional incisions, which are used in open repair. Complex or large tears may require this type of procedure. A surgeon uses an arthroscope (an arthroscope) to guide surgical instruments through a small incision into the shoulder to perform the arthroscopy. The procedure is less invasive and involves a smaller incision.

In either case, the rehabilitation period is extensive. A sling or other immobilization device is applied for four to six weeks to immobilize the shoulder joint. The physical therapy begins once the sling has been removed with passive exercises that are performed by the physical therapist. Physical therapy exercises to strengthen the arm may be started between 8 and 12 weeks after surgery.

Recovery & Prognosis

Depending on where the rotator cuff is torn, the prognosis is different. About half of patients with rotator cuff injuries can have their back pain relieved and their shoulder function restored with nonsurgical treatment. Physical therapy and cortisone injections can sometimes be used as part of conservative treatment.

The recovery time is longer if surgery is required. In addition to immobilizing the shoulder for four to six weeks, physical therapy is required. When returning to vigorous activity after shoulder surgery, it usually takes about three months to start performing light activities above shoulder height.

If you have above symptoms and conditions, WeCare Medical Specialty Group can help you. We have five offices across Northern Jersey. Please call our office at (973)996-2990 or book an appointment online immediately.