A Rotator cuff tear appears at the group of muscles and tendons surrounding the shoulder joint, what is commonly referred to as rotator cuff. The tendon is what attaches the muscles to the body. There are four tendons and muscles in the rotator cuff, subscapularis, infraspinatus, supraspinatus, and teres minor. When one or more tendons of the rotator cuff muscles is torn, that condition is referred to as a rotator cuff tear. The most commonly torn tendon is that connecting supraspinatus, this is because it passes between the acromion and the top of the humerus. A torn rotator cuff can also occur with an injury to the muscle if the injury is prolonged for a long period it can lead to the muscle tearing in two leading to a tear. The causes are associated with age, posture, injury, carrying heavy loads or overusing the shoulder and upper body weakness.
The main symptoms are pain, being unable to sleep on that shoulder, crackling sound when performing any motion with the shoulder and shoulder weakness. Torn rotator cuff pain varies depending on the seriousness of the tear. Other rotator cuff tear symptoms is limited shoulder motions especially overhead movements of your arm. Diagnosis of a tear include evaluating the rotator cuff injury a thorough physical exam performed by your doctor, you will be instructed to move the arm in different directions to determine the cause of pain. Additionally the doctor may recommend an X-ray, MRI or an arthrogram, which is a special type of x-ray requiring a dye to be injected to your joint to enhance visibility. These additional tests are done to rule out other conditions.
Once the symptoms have been confirmed, a non-operative treatment is first recommended to treat the tear. Non-operative treatment is varied. They include anti-inflammatory medication, cortisone injections, resting the arm, sling, exercises, and physical therapy. Doctors mostly use these in combination to heal your tear. For example, medication and exercises or physical therapy and a sling.
Surgery is only done if the other types of treatment have not produced results and there is continued pain. Rotator cuff surgery is done to repair the torn rotator cuff. A partial tear is corrected with a procedure known ad debridement whereby only smoothing and trimming is done. Stitching to bring back two sides together is done where there is a complete tear at the thickest side of the tendon. Surgery may also involve reattaching the torn tendon to the top of the upper arm bone, the humerus. Other options can be either the traditional open surgery or arthroscopic rotator cuff repair. The trend nowadays is leaning towards arthroscopy due to its short recovery period. The ability of the patient to stick to the post surgery rehabilitation, immobilization and exercises, and avoid putting stress on the injured arm or avoiding another injury is what will ultimately impact on the healing of the rotator cuff tear after surgery.