An Overview of Shoulder Anatomy and Rotator Cuff Tears
The rotator cuff located within the shoulder is made up of tendons and muscles. These shoulder elements connect the upper arm bone with the shoulder blade and they are in place to help hold the ball of the upper arm bone firmly to the shoulder socket. All of these biological functions come together to create the greatest range of motion of any joint in the human body.
Rotator cuff injuries are very common. They can occur when any irritation or damage affect the rotator cuff muscles or tendons. Many activities can lead to this type of injury including falling, lifting, repetitive overhead arm activities and degeneration of the rotator cuff tendon. The incidence of rotator cuff damage increases with age.
There are 3 distinct rotator cuff conditions:
- Strain or Tear
Tendinitis occurs when the rotator cuff tendons become inflamed due to overuse or overload. Athletes will often find themselves with this condition if they are involved in daily or routine overhead sports such as tennis or basketball. Bursitis is an inflammation that occurs when the fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons become irritated. This can also be a cause of overhead activity or overuse of the shoulder muscle. If the first two conditions are not dealt with, a person could experience a strain or tear in the rotator cuff region, which will require a more drastic treatment approach.
Rotator Cuff Tear Patterns Video
Symptoms of a Rotator Cuff Injury
The most common symptoms associated with a rotator cuff injury are sharp shoulder pain and shoulder tenderness. Everyday activities such as scratching your head, putting on a shirt, laying down on the affected side and carrying a moderately light object will create pain over regular use of the arm. There will be an overall weakness in your arm and this weakness and pain will create anxiety that will prompt you to keep our shoulder inactive.
Treatments for Rotator Cuff Injuries
Rotator cuff injuries are very common problems and can many times be healed without treatment. If a patient has a mild rotator cuff injury, it is important to keep the hurt shoulder inactive with plenty of rest. Apply ice daily and use an anti-inflammatory medicine to help with any swelling and pain.
If the shoulder does require surgery, minimally-invasive arthroscopic surgery can usually repair the milder degree rotator cuff injury. In the event arthroscopic surgery does not work or is not recommended due to a more severe rotator cuff injury, there are other options that will treat the condition.
‘Double-Row’ Arthroscopic Rotator Cuff Repair
For patients who have significant injuries to the rotator cuff, or who are experiencing recurrent shoulder problems and defects after open and/or arthroscopic surgery has been performed, a double-row arthroscopic rotator cuff repair might be recommended. The double-row arthroscopic repair technique typically improves the overall quality of the rotator cuff restoration process. ‘Double row’ refers to the way the tendons are repaired—with a double row of sutures rather than just a single row.
Rotator Cuff Repair Video
Rotator Cuff ‘Healing Response’ Technique
The rotator cuff healing response technique is a novel procedure that uses the body’s own stem cells and bone marrow to help repair damaged rotator cuff tendons. This arthroscopic procedure involves making tiny “microfracture” holes in the bone; the blood clot from the bone that releases blood captures the end of the injured muscle and eventually reattaches the ligament back to the bone. No sutures are needed with this repair technique so patients have rapid recoveries.
Tendon Transfer for Failed Rotator Cuff Repair
Sometimes, open or arthroscopic rotator cuff surgery fails to work. In a massive rotator cuff tear good results can occur through a tendon transfer. A tendon transfer is a surgical procedure by which a tendon and its muscle are moved from one location to another. This procedure is completed so that lost function of the shoulder can be regained. This procedure requires technical skill from the surgeon and is more of an undertaking than basic rotator cuff repair surgeries; it is often a last step or salvage surgery.