ROTATOR CUFF TEAR

In order to understand your rotator cuff tear you will need a bit more information on the anatomy of the shoulder and how it relates to shoulder injuries. The information on this page should help.

Shoulder injuries are common among all ages, but tend to be more widespread with growing age. The shoulder is formed of 3 bones (the collar bone or Clavicle, the shoulder bade or the Scapula and the upper arm bone, better known as Humerus), and is a vital joint in the upper portion of the human body. It attaches the upper arm with the upper portion of our bodies. The shoulder also has 4 small muscles namely - Supraspinatus, Infraspinatus, Subscapularis, and Teres minor. These 4 muscles form a single tendon unit. This unit gives the allows the various shoulder movements and stability of the ball and socket joint at the shoulder. A rotator cuff tear would literally mean the fractional or complete ripping of 1 or more of any of the shoulder muscles, causing temporary or permanent damage. In severe cases, surgery is required to fix a rotator cuff tear.

CAUSES

A rotator cuff tear is usually the result of a sudden and acute fall. Though most common in the people above 40 it is not uncommon among young people. People, who are into repetitive overhead jobs, like construction, stocking shelves or even painting, are prone to rotator cuff tears. Swimmers, tennis players, pitchers and other such athletes, who have to continuously stretch the upper portion of their bodies, are also very susceptible to injuries of the shoulder or rotator cuff tears. People suffering from prolonged or repetitive trauma are also likely to suffer rotator cuff injuries. It is also common among people who have shoulder bone dislocation or fractures.

SYMPTOMS

Symptoms of a rotator cuff tear usually show slowly. The pain may be really mild at the onset and gradually intensify with repeated overhead activity and wear and tear of the muscles and inflammation is common. The pain is usually felt at the front of your shoulder and spreads down the arm. Mild shoulder pains are often ignored and treated with over the counter prescriptions. However, if there is a real case, the pain gradually increases and is felt at very little activity or even at rest. You might feel pain while lying down on the affected side. Stiffness and consequent loss of motion result. If the rotator cuff snaps suddenly because of a fall or fracture, one can usually feel the snapping of the muscle and an instantaneous weakening of the arm. Acute pain is felt in such cases.

TREATMENT

There are several options open for the treatment of rotator cuff tears. After a thorough diagnosis of the affected area is made, the doctor is in the position to decide whether a surgery is required or not. In many cases, doctors opt for non-surgical treatments that include the using a sling for the affected arm, medication to relieve the pain and inflammation, steroid injection and the likes. Above all the before mentioned prescriptions, doctors advise complete rest or extremely limited activity and gradual strengthening of the affected shoulder by exercises and physiotherapy.

Surgery is advised when the non-surgical means cannot bring relief to the patient. Surgery is essential if the rotator cuff tear is acute and highly painful, or in cases where the dominantly active arm of the person or athlete or worker is the casualty. The nature of the surgery depends on the location and amount of the tear. Small snaps may be treated by simple ‘trimming’ or ‘smoothing’. Complete ripping of the muscle/ tendon requires a suturing process to bring the two portions together. The rehabilitation process requires a complete immobilization of the operated arm. An exercise regime is prescribed that gradually helps the patient to regain mobility.

Recent surgical procedures involve reducing incisions to the minimal levels and emphasising on quick recovery. Dissolvable anchors are used which are useful in holding the stitches to their place until the area heals and the stitches dissolve within the body. "Orthobiologic" tissue implants are the latest subject of research, as these promote tissue growth, facilitating the healing process.