What is rotator cuff  and what happens in it?

The rotator cuff is a group of 4 muscles that unit together as tendon to form a cuff over the head of humerus (upper arm bone). These 4 muscles originate from scapula and attach to a special spots, named to as greater and lesser tuberosities

The rotator cuff assists to rotate the arm and stabilise the ball of shoulder within the joint.

What causes a rotator cuff tear and how would I know if I have one ?

A rotator cuff tear may result from an acute injury, such as fall, sport injury or it may be caused by age related wear and tear with aging.

Typically, you will feel pain in the front of your shoulder that radiate down the arm.

It may aggravate with overhead activities such as hair combing, lifting any object, sleeping on affected side. You may have weakness in your arm and difficulty with routine activities such as hand reaching behind your back.

If the tear happens because of acute injury, then you may experience acute pain, snapping sensation and immediate weakness of the arm.

If I have a painful rotator cuff and keep using it (ignore it) would this cause further damage?

If you use the shoulder muscle movements repetitively (over used) then it can extend or get bigger over time.

If you ignore the initial acute pain, because of tear and if patient experiences worsening pain and decreasing strength, then it means tear is getting bigger.

When shoulder I consult doctor for a rotator cuff tear?

If you have chronic shoulder and arm pain, or you have injured shoulder, it is best to see your pain management specialist. Your physician may recommend a diagnostic imaging study such as MRI or ultrasonography to confirm diagnosis.

Early diagnosis and treatment of a rotator cuff tear may prevent symptoms such as loss of strength and loss of motion.

Can a rotator cuff tear be healed or strengthened without surgery?

Many of rotator cuff tear, can be treated non-surgically with over intervention technique.

Anti-inflammatory medications, steroid injection, PRP therapy followed by physical therapy may heal your tear.

The goal of treatments are to relieve pain and to restore strength of the affected shoulder.

When rotator cuff tear require to fix it?

If you have persistent pain or weakness in your arm that does not improve with non-surgical treatment, if you have night pain, difficulty using the arm for lifting and reaching then surgery is required.

What options are available for surgical repair ?

It depends upon partial tear or complete tear or site of tear.

A full thickness tear within the substance of the tendon can be repaired side to side.

If the tendon is torn from its insertion on the humerus, it is repaired directly to bone.

These techniques are used for rotator cuff repair :  traditional open repair, mini open repair and arthroscopy repair.

How important is rehabilitation in the treatment of a rotator cuff tear?

Rehabilitation plays a vital role in both non-surgical and surgical treatment of rotator cuff tear.

Because of tear, there is frequently atrophy of the muscle around the arm and loss of range of movement. To restore the function of joint, physiotherapy is necessary. Even though surgery repair the defect in the tendons, the muscles around the arm might be weak or stiff. For the surgery succeed, strong effort at rehabilitation is necessary.