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When the Rotator Cuff Tears

By Neil C. Dunleavy, MD, FAAOS, Orthopedics & Sports Medicine, CareMount Medical
July 19, 2021

A tear or injury to the rotator cuff, an important part of your shoulder, can be painful and debilitating.

To understand the significance of the rotator cuff, it is important to understand what it is and what it does. The rotator cuff is comprised of four muscles and their associated tendons that form a covering around the humeral head of the shoulder. Your rotator cuff helps to raise and rotate your arm, and also assists in keeping your shoulder in its socket.

Rotator cuff tears account for an estimated two million doctor visits each year in the United States alone, according the American Academy of Orthopedic Surgeons, and are the most common cause of shoulder pain and weakness in adults, leading to significant disability. Younger persons and seniors can both be affected, though incidence increases with age.

Rotator cuff tears can occur as the result of trauma from a specific injury such as a fall. They may also be due to chronic degeneration over a long period of time, often as a result of repetitive physical activity involving the shoulder. Tears can be small or large, partial or complete, and can present in a number of different patterns, shapes and sizes. Magnetic Resonance Imaging (MRI) is often very helpful in diagnosing rotator cuff tears and their severity.

Symptoms associated with rotator cuff tears can often improve with rest, physical therapy and anti-inflammatory medications. When pain and weakness due to a rotator cuff tear persist, or in the setting of a specific injury with resulting dysfunction in an active individual, surgery may be appropriate.

Not all tears are the same, so each repair is tailored to the specific needs of an individual patient. Surgical repair is typically minimally-invasive, with a few very small incisions around the shoulder. A small camera called an arthroscope is inserted into the shoulder, the rotator cuff tear is visualized and repair is accomplished with the latest high-tech methods, often with materials that absorb into your bone over time and do not need to be removed.

Surgery is often performed as an outpatient procedure, and patients may return home on the same day. Postoperative physical therapy is tailored to each patient as well and progresses in stages, with an initial period of rest, followed by recovery of motion and finally, strengthening of the shoulder.

The goal of rotator cuff surgery is to decrease your pain, improve your function, and help you return to the activities you love to do. Not all tears are the same, so not all repairs should be the same either.

If you have shoulder pain, or if you think you may have a rotator cuff tear, please click here  or call for an appointment.