What is the Rotator Cuff and what does it do?
In most parts of the body, the bones are surrounded by muscles. In the shoulder region, however, the muscle is surrounded by bone. Underneath that bone is the muscle that lifts the arm. The rotator cuff muscles of the shoulder are sandwiched between the arm bone and the top of the shoulder (acromion).
The Rotator cuff is a group of four muscles that come together as tendons to form a “cuff” over the head of the humerus (upper arm bone).
The Rotator cuff helps to lift and rotate the arm and to stabilize the ball of the shoulder within the joint.
What causes a Rotator Cuff tear and how would I know if I have one?
A rotator cuff tear may result from an acute injury, such as a fall,repetitive use or a re-injury. It may be caused by normal age-related wear and tear with degeneration of the tendon.The risk of rotator cuff injury also increases with age.
You may feel Tears that happen suddenly, such as from a fall, usually cause intense pain & immediate weakness in affected arm.
Pain at rest and at night, particularly if lying on the affected shoulder
Pain when lifting and lowering your arm or with specific movements
Weakness when lifting or rotating your arm
Crepitus or crackling sensation when moving your shoulder in certain positions
Can a Rotator Cuff tear be healed or strengthened without surgery?
Many Rotator cuff tears can be treated non surgically .
Anti-inflammatory medication, steroid injections, and physical therapy may all be of benefit in treating symptoms of a cuff tear.
The goals of treatment are to relieve pain and restore strength to the involved shoulder.
Even though most tears cannot heal on their own, good function can often be achieved without surgery.
If, however, you are active and use your arm for overhead work or sports, then surgery is most often recommended because tears will not heal without surgery.
At what point does a Rotator Cuff tear require surgery to fix it?
Surgery is recommended if you have persistent pain or weakness in your shoulder that does not improve with nonsurgical treatment.
Surgery is also indicated in active individuals who use the arm for overhead work or sports. Pitchers, swimmers, and tennis players are common examples.
Surgery For Rotator cuff repair
Rotator cuff repair was done by an open surgical procedure in old times, which typically requires large incision at the top of the shoulder. Arthroscopic techniques for Rotator cuff repair is preferred option now a days. I have been using arthroscopic technique successfully in all my patients with gratifying results.
You will likely receive general anesthesia for this surgery. This means you will be asleep and unable to feel pain.
During the procedure, the surgeon
Inserts the arthroscope into your shoulder through a small incision.
Inspects all the tissues of your shoulder joint and the area above the joint for other injuries also.
The type of repair performed is based on the findings at surgery. The torn edges of the Rotator cuff tendon are brought together and re-attached to bone with the help of specials anchors.
Unlike the open technique ,the portals used for an arthroscopic repair are very tiny. There may be 3 to 4 of such very small 5mm portals, the patients have much less postoperative pain and require less prescription pain medication, postoperative recovery is faster and superior.