Rotator Cuff Tears, Injuries and Treatments

Author:

Dr. Gururaj S Puranik, Senior Consultant Trauma and Orthopaedics

A rotator cuff is a group of 4 muscles which surround the shoulder joint, which are attached to the bone via tendons. These muscles & tendons help keep the shoulder in socket & help control movements

Causes

  • The tendon/s are damaged/ torn through “wear and tear” or following an injury

Symptoms

  • Pain at rest & at night, particularly if lying on the affected shoulder
  • Pain when lifting and lowering arm
  • Weakness when lifting arm

If you have a rotator cuff tear and you keep using it despite increasing pain, you may cause further damage. The tear can get larger over time

MRI/Ultrasound shows the rotator cuff tear, as well as where the tear is located within the tendon & the size of the tear

Treatment

  • Depends on age, activity level, general health & the type of tear
  • Rest by using a sling to help protect the shoulder
  • Avoid activities that cause shoulder pain
  • Pain killers
  • Exercises (stretches) to improve flexibility & range of motion + strengthening the muscles that support the shoulder can relieve pain and prevent further injury

If rest, medications & exercises do not relieve pain, an injection of a local anaesthetic & steroid may be helpful

Surgery is indicated if

  • Continued pain in spite of the above treatment
  • The tear was caused by a recent, acute injury
  • Symptoms lasting more than 6 to 12 months
  • Significant weakness and loss of function

Surgery involves re-attaching the tendon to the head of the humerus (upper arm bone) by keyhole surgery or as an open procedure.

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