Rotator cuff tear
What is it?
This term is used to describe damage to the four muscles that surround and stabilize the shoulder joint.
Why does it occur?
Complete or partial tears to the rotator cuff may be cause either by trauma to the shoulder, or by degeneration over time. Rotar cuff tears are most common in people over the age of 40, and of this group, those who perform repeated overhead movements are more susceptible to this injury. In the latter, they occur most frequently in the dominant arm.
What are the symptoms?
Pain around the joint, often exacerbated by activity involving overhead movements, is the most common symptom. A feeling of weakness and stiffness in the joint that limits normal activities, can also occur. Some patients can experience pain when sleeping on the affected shoulder. A crackling sensation may also be present when moving the shoulder, caused by inflamed bursa (fluid sacs) surrounding the joint.
How is it diagnosed?
A detailed history and examination to determine the mechanism of the injury, and decide on appropriate treatment, is essential. X-ray, ultrasound and MRI scans are often used so your surgeon can confirm the diagnosis.
How is it treated?
Many rotator cuff tears can be managed with pain relief, physiotherapy exercises, and steroid injections. Whether this course of action is best for you will depend on the extent of damage to the rotator cuff and any other medical conditions you might have. In most cases, the restrictions on function due to a tear can be minimal, and steroid injections can be very effective in reducing inflammation.
This is performed using arthroscopy or keyhole surgery, in which, using a special instrument, a very small hole or holes are made in order to look at a joint, and sometimes to repair it at the same time.
An anaesthetic block is used to numb the arm, which can last for several hours after the procedure. You can usually return home the same day, after seeing the ward physiotherapist, but recovery can be a slow process.
The One Orthopaedics team specialists
Consultant Orthopaedic Specialist FRCS (Tr & Orth)