Rotator cuff tears
Rotator cuff tears can make the simplest of movements, like reaching for something on a shelf, excruciatingly painful. The shoulder is a complex joint with great range of motion. However, it is not a stable joint, which makes it vulnerable to problems. Because rotator cuff tendons are key to the healthy functioning of the shoulder joint, rotator cuff tears weaken the shoulder joint.
Tendons attach muscles to bone. Muscles use the tendons to move the bones. In the shoulder joint, the tendons of four muscles form the rotator cuff. Used together, these tendons – the rotator cuff – connect two of the three bones in the shoulder and help to raise the arm and rotate it.
Causes of rotator cuff tears
Although rotator cuff tears can occur at any age, they are more common in late middle age, as the natural degeneration associated with aging begins to take its toll on the joints. Overuse of the arm in a repeated fashion is often a factor in a rotator cuff tear. Think baseball pitchers. But you don’t have to be an athlete to suffer from a rotator cuff tear. Even routine chores like washing windows or washing cars can cause the rotator cuff to fatigue from overuse.
Rotator cuff tears can be partial or complete. A partial tear may not make itself known apart from mild shoulder pain and perhaps limited movement of the shoulder. In complete rotator cuff tears, it is usually impossible for you to raise your arm away from your side by yourself.
Diagnosis of rotator cuff tears
After a physical examination, your surgeon may order other tests to determine the extent of your rotator cuff tear. X-rays can show if bone spurs, calcium deposits or other bone-related conditions caused the tear. He may inject dye into your shoulder joint before taking the x-rays, as the dye will indicate a leak in the joint. He may order an MRI, which will show changes in both tendons and bones.
Treatment of rotator cuff tears
Controlling pain and inflammation is the first order of business in treating rotator cuff tears. Rest and over-the-counter anti-inflammatory medication (aspirin or ibuprofen) are the first line of defense. A cortisone injection may be the next step. Physical therapy and a course of heat and ice applications will likely follow. Most patients are able to get back to their regular activities with six to eight weeks of therapy treatments.
Complete rotator cuff tears require surgery to return your shoulder to optimal function. Arthroscopic shoulder surgery is minimally invasive and can usually be performed on an outpatient basis. Your surgeon will clean out the shoulder joint, removing any torn or degenerative tissue. Then the torn rotator cuff tendon will be reattached to the bone using special devices called suture anchors.
In some cases, open surgery may be required, or a tendon graft may be necessary. These are the exceptions to the rule. But in any case, rehabilitation from rotator cuff surgery is slow, generally taking six months or more.