Rotator Cuff Tears

Rotator cuff Surgery

Smooth and Move Procedure

Reverse Shoulder Arthroplasty (replacement)

Rotator cuff problems are some of the more common and frustrating issues that patients can deal with throughout their lives.  Rotator cuff issues can weaken your shoulder and make activities of daily living, like combing your hair or getting dressed painful and difficult to do.

What is the rotator cuff?

Your shoulder is made up of three bones: your upper arm bone, called the humerus, your shoulder blade, called the scapula, and your collar bone, called the clavicle.  Your arm is kept in your shoulder socket by the rotator cuff.  The rotator cuff is a group of four muscles that come together to form tendons that cover the head of your humerus.  The rotator cuff attaches to the humerus and allows you to lift and rotate your arm.  

On top of your rotator cuff, you have a lubricating sac called the bursa.  The bursa allows your rotator cuff to freely glide when you move your arm.  Sometimes, the rotator cuff or the bursa become inflamed and painful.

What causes rotator cuff problems?

Rotator cuff problems can fall along a wide spectrum of issues.  The most common is inflammation of the rotator cuff called rotator cuff tendinitis.  Along with this issue is inflammation of the bursa sac called bursitis.  Sometimes, the rotator cuff tears off of the humerus bone.  This can range from a small, partial tear of the rotator cuff tendon to a complete tear of the rotator cuff tendon.  Many times, complete rotator cuff tears begin with minor tendinitis that progress to partial tearing and then complete tear.

There are two main causes of rotator cuff tears: injury and degeneration.
Injury to your rotator cuff is usually caused by lifting something very heavy with a jerking motion.  This can tear the rotator cuff tendon off of the humerus bone.

Degenerative tears are by far the most common type of rotator cuff tears.  These tears are often caused by wearing down of the tendon slowly over time.  This type of tear usually starts with tendinitis and progress to partial thickness tears and complete tears.  These can be due to repetitive stress or just wear over time.

How Do I know if i have a rotator cuff tear?

The most common symptoms of rotator cuff tears are:

• pain at night, especially if lying on the affected shoulder

• pain when lifting or lowering your arm or with specific movements

• weakness when lifting or rotate your arm

• cracking or popping sensation when moving her shoulder in certain positions, especially overhead

Tears that happen suddenly, such as from a fall or when lifting something heavy usually cause intense pain.  You may also notice that you are unable to lift your arm after this injury.
Tears that develop slowly due to overuse, usually begin by some vague pain in her shoulder that progresses to worsening pain and then significant pain and weakness.

Some rotator cuff tears, especially those that occur slowly over time, are sometimes not painful.  These tears, however, may still result in some weakness and other symptoms.

Rotator cuff tears can be diagnosed with history and physical examination on most occasions.  Sometimes, advanced imaging such as MRI or ultrasound can be used to confirm a diagnosis of a rotator cuff tear.

how do i treat my rotator cuff tear?

Nonsurgical treatment is usually based on avoiding activities that cause shoulder pain, nonsteroidal antiinflammatory medications, and extensive shoulder stretching at home or with physical therapy.  Often times, the pain in your shoulder is secondary to shoulder stiffness.  Once the stiffness has been resolved, the shoulder pain improves significantly.  In the past, many physicians have recommended steroid injections into the shoulder.  Many shoulder specialists, like myself, do not recommend this course of treatment often due to its negative effect on the rotator cuff tendon.  Steroid injections can make the rotator cuff tendon weaker and more prone to more extensive tearing.

If you had a significant injury that resulted in a rotator cuff tear or you have not improved with extensive physical therapy and home exercises, minimally-invasive rotator cuff surgery may be an option for you.  To learn more about rotator cuff surgery, continue reading here.