Rotator Cuff Tear

WHAT IS IT?

The rotator cuff is a group of tendons that connects the four muscles of the upper shoulder to the bones The strength of the cuff allows the muscles to lift and rotate the humerus (the bone of the upper arm). A tear may result suddenly from a single traumatic event or develop gradually. When the tendons or muscles of the rotator cuff tear, the patient is no longer able to lift or rotate his or her arm with the same range of motion as before the injury . The pain is also very common at night, often radiating down the arm.

As people age, it is normal for the rotator cuff tendon to wear and degrade. The rotator cuff becomes weak and prone to rupture or tear. A fall or wrenching injury can then result in complete rupture of the tendons. This leads to pain and weakness of the shoulder.

CAUSES:

  • Injury, especially while trying to lift or catch a heavy object
  • Overuse, especially after a period of inactivity
  • Poor blood supply to an area of the cuff (which occurs with increasing age)
  • A fall on an outstretched hand
  • A gradual weakening of the tendons of the shoulder, often associated with impingement

PREVENTION:

Avoid excessive overhead activities.
Strengthen your shoulders and do not try to play or work through the pain.

TREATMENT:

  • Painkillers and anti-inflammatory medications
  • Physiotherapy – keeps your shoulder strong and flexible and reduce the pain and weakness
  • Surgery is required –
    • If the tear follows an injury
    • When pain and weakness is not improved with medicine and physiotherapy

– The goal of any surgery is to relieve the pain and improve the shoulder strength. This requires a long period of physiotherapy in addition to the surgery.

– Surgery may be done (keyhole) Arthroscopy or Open, or a combination of the two, know as a Mini-repair.

– Some tears are too large to repair and are known as ‘Massive cuff tear’.

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