The rotator cuff is the group of tendons in the shoulder joint providing support and enabling wider range of motion. Major injury to these tendons may result in tear of these tendons and the condition is called a rotator cuff tear. It is one of the most common causes of shoulder pain in middle-aged adults and older individuals.
Rotator cuff tear can result from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted. It may occur with repeated use of the arm for overhead activities, while playing sports or during motor accidents.
Rotator cuff tears cause severe pain, weakness of the arm, and crackling sensation on moving shoulder in certain positions. There may be stiffness, swelling, loss of movements, and tenderness in the front of the shoulder.
Your surgeon diagnoses a rotator cuff tear based on the physical examination, X-rays, and imaging studies, such as MRI. Rotator cuff tears are best viewed on magnetic resonance imaging (MRI).
Conservative Treatment Options
- Shoulder sling for a brief period
- Anti-inflammatory medication
- Injection of a steroid (cortisone) and a local anesthetic in the subacromial space of the affected shoulder to help decrease the inflammation and pain
- Exercises or formal physical therapy
Rotator cuff repair may be performed by open surgery or by a minimally invasive arthroscopic procedure. In arthroscopy the shoulder is viewed with a special camera and the cuff tear is repaired using special arthroscopic devices and suture anchors. These anchor sutures help in attaching the tendons to the shoulder bone. Following the surgery, you may be advised to rest the shoulder in a sling and then start a rehabilitation program with physical therapy.