Rotator Cuff Tear
What is it?
The rotator cuff is a group of tendons (the structures which attach muscles to bone) which envelope the humeral head (Ball part of the joint), rather like an unbuttoned shirt cuff.
Essentially it is a continuous sheet of tough tissue from the front, over the top and behind the humeral head, but absent underneath.
It is prone to wearing out as we get older, and can do so in a gradual manner, but also more rapidly if an injury to the shoulder occurs.
Symptoms and Treatment
Common symptoms include pain, night pain and weakness in shoulder movement. They can also present with symptoms of impingement.
Scientific studies have demonstrated that the likelihood of having a tear increases, as we get older, however people can be without symptoms, not realising that a tear is present. As a result treatment is aimed at those tears that are symptomatic.
Often a scan (MRI or Ultrasound) is needed to assess the extent of the tear and to help guide treatment.
A physiotherapy programme facilitated by a cortisone injection into the shoulder can be enough to improve or resolve the symptoms, but it is important to remember that the tear will not heal back into place, just that the symptoms will get better.
For larger symptomatic tears, surgery is often needed, and this is usually performed by either a keyhole or mini-open repair.
Sometimes the tear is so large and so degenerate it is not possible to repair it, despite that, other treatments are available for this scenario.
Usually rotator cuff repair is performed as a day case and is done through 2-3 very small incisions in the shoulder, that don’t even require stitches. The aim of the surgery is to repair the torn tendon.
You will require a sling/immobilization of the shoulder for several weeks, to protect the repair from excessive movement. As a result of that, post-operative rehabilitation, under the direction of a physiotherapist, cannot fully commence until the sling is removed.
It is likely that your full recovery will take several months, to regain the strength and movement of your shoulder.