Rotator Cuff Tears
Rotator cuff tears refer to injuries that involve the tearing or detachment of one or more of the tendons in the rotator cuff. The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, providing stability and enabling various shoulder movements.
There are two main types of rotator cuff tears:
- Partial-thickness tear: This type of tear affects only a portion of the tendon. It may start as a small tear and progress over time if not treated.
- Full-thickness tear: This type of tear involves a complete rupture or detachment of the tendon from its attachment site on the bone. It can occur suddenly due to trauma or develop gradually over time due to degenerative changes in the tendon.
Rotator cuff tears can be caused by various factors, including:
- Acute injury: A sudden traumatic event, such as a fall, lifting a heavy object, or a direct blow to the shoulder, can cause a rotator cuff tear.
- Degenerative changes: Over time, the tendons of the rotator cuff may undergo wear and tear, leading to degeneration and weakening. This makes them more prone to tears, especially in older individuals.
- Overuse or repetitive motion: Repetitive overhead activities or activities that involve repetitive stress on the shoulder joint, such as throwing, lifting, or certain sports movements, can contribute to the development of rotator cuff tears.
Rotator Cuff Tear
The most common muscle to tear is the supraspinatus muscle. It is located at the top of the humerus and is involved in elevating your arm above your head.
Rotator Cuff Repair
The rotator cuff is repaired back to bone using specialised anchors. The anchors have several sutures inside them which are used fix the rotator cuff tendonsback to bone.
The treatment for a rotator cuff tear depends on various factors, including the size, location, and severity of the tear, as well as your symptoms, functional goals, and overall health. If you have a full thickness cuff tear that has occurred because of an injury or are experiencing loss of function you may benefit from surgery. The broad treatment options are:
- Rest and activity modification: Avoid activities that aggravate the symptoms and allow the shoulder to rest and heal.
- Physical therapy: Specific exercises and stretching to strengthen the surrounding muscles, improve shoulder mechanics, and restore range of motion.
- Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, or other medications to reduce pain and inflammation.
- Modalities: Heat or cold therapy, shockwave therapy, laser therapy, or electrical stimulation to alleviate pain and promote healing.
- Arthroscopy: A minimally invasive procedure in which small incisions are made, and a tiny camera and surgical instruments are used to repair the torn tendon.
- The rotator cuff is repaired back to bone using specialised anchors. The anchors have several sutures inside them which are used to tie down the rotator cuff tendons and to compress them against your bone.
The symptoms of a rotator cuff tear can vary depending on the severity and location of the tear. Common symptoms include:
- Pain: Typically felt deep within the shoulder, which may worsen with arm movements, especially those involving lifting or reaching overhead.
- Weakness: Difficulty or weakness in performing certain shoulder movements or lifting objects.
- Limited range of motion: Reduced ability to move the shoulder fully, particularly in abduction (raising the arm to the side) and external rotation (rotating the arm outward).
- Shoulder stiffness: A feeling of stiffness or loss of flexibility in the shoulder.
Recovery after Rotator Cuff Surgery
The rotator cuff is repaired back to bone using specialised anchors. While these anchors are strong, it relies on your body to heal the rotator cuff back to bone. This usually takes at least three months. During this time, you need to protect the repair by restricting your activities to some degree. After your tendons have healed, your shoulder needs to regain its strength, which frequently takes another 6-9 months. Your physiotherapist will guide you through the stages of rehabilitation.
Stage 1 – Protect Repair
- In the first six weeks the repair needs to be protected
- You can start on some early range of motion from two weeks
- You will need to wear a sling during this time
Stage 2 – Increase Range of Motion
- This stage covers weeks 6-12
- The sling is gradually weaned
- You start on active range of motion
- Low-resistance strengthening is introduced
Stage 3 – Strengthening
- The next three months you focus on strengthening
- Resistance training is increased
- You can return to swimming
Stage 4 – Return to full activities
- From six months onwards you can return to full activities
- You can return to sports and manual work
Please use above information as a guide only. More detailed information specific to your condition and your recovery will be given in your consultation with Dr. Arthur Turow, who will also provide additional resources to supplement your discussion. For more information, please contact the rooms of Dr. Arthur Turow on (08) 8236 4179.