Rotator Cuff Tear

Rotator cuffs usually weaken in one’s 30s, and partial tears become common in those over 40. Usually they go unnoticed due to no pain, and whether treatment is needed depends from case to case. Rotator cuff is what helps us lift and rotate our arms. It consists of a group of four tendons and muscles that meet around the shoulder joint. Basically, the muscles and tendons facilitate movement whilst keeping the top of the upper arm bone in the shoulder socket.

Treatment for tears vary from patient to patient, based on the clinical symptoms, x-ray results, patient age, tear size, time since injury occurred and muscle strength. It also depends on shoulder mobility prior to surgery and findings during surgery, such as unaffected tendons and muscle atrophy. 

An acute traumatic rotator cuff tear is more common in young people. In these cases, after the tendon is repaired with arthroscopy, a rehabilitation program can start  right away. Degenerative tears are more common in older adults. In such cases, an open tendon repair may be a better option due to the larger tear and impaired tissue. Performed through a larger incision, open tendon repairs typically cause postoperative pain and require a longer recovery time. The success rate of the surgery depends on the requirements, type of surgical procedure performed, the surgeon’s level of experience and compliance with rehabilitation after surgery.

• Acute pain in the shoulder
• Sudden pain, like pain from a cut
• Difficulty lifting the arm and weakness in the arm
• Hearing your shoulder “POP”
• Crackling sounds when moving the shoulder
• Inability to sleep on the affected shoulder

 ‘It’s not’  if your daily routine daily activities do not aggravate the injury, and your work does not involve forward elevation of the arm. Instead, for such cases conservative treatments such as anti-inflammatory medications, pain medications, physical therapy, and shoulder exercises can be an option. Additionally, you should also avoid activities or sports that may cause injury as the tear could become larger, leading to shoulder osteoarthritis.   

“It is” if your work or sports activities require physical efficacy or if the rotator cuff tear affects your daily activities due to weakness in the arm. In these cases, surgery will likely be necessary. The best rotator cuff tear treatment results occur when the rotator cuff injury is still fresh. However, there are certain points that patients need to know prior to the surgery:

• Patients should stop smoking and taking anti-clotting medication one week prior to the surgery. 
• Functionality in the shoulder should slowly come back to near normal after surgery.

Surgery is performed to repair a torn tendon in the shoulder, not to increase muscle strength. Hence, a rehabilitation program after surgery is very important to improve functional outcome, recover the nerve, and increase muscle strength.