The rotator cuff is a group of four muscles and tendons that extend from the shoulder blade (scapula) to the ball of the humerus. These four muscles function to stabilize the shoulder and allow for active motion of the arm. Rotator cuff tears may be chronic as the result of repetitive motion or a bone spur in the shoulder. They can also be acute, as in the case of a fall onto the shoulder or arm. A rotator cuff tear may require rotator cuff surgery depending on how severe the tear is.
Patients with rotator cuff tears typically have pain in their shoulder when trying to lift an object away from their body. The shoulder may feel weak and movement can be associated with a popping or grinding sensation. Some patients are very well compensated after a rotator cuff tear, and may actually not have any symptoms at all, while others cannot move the arm and are extremely painful.
Tendons in your body attach muscles to bones. When the muscle contracts its tendon transmits a force from the muscle across a joint to the bone. The four muscles of the rotator cuff start on the shoulder blade, and insert onto the humerus. When one of these muscles contracts it causes the shoulder to rotate inward, outward or forward. That is why it is called the rotator cuff. A bone spur in the shoulder can wear away at the tendons of the rotator cuff, or a fall onto the shoulder or arm can tear this cuff of tendons. When the rotator cuff tears the tendons can no longer transmit the force of the muscle to the bone, and pain and weakness are the result.
Depending upon the size of the rotator cuff tear, the age of our patient and their symptoms, we may recommend rotator cuff surgery or non-surgical treatment of a rotator cuff tear. If we recommend a non-operative approach, we prescribe pain medication and physical therapy. Surgical management of a rotator cuff tear is done arthroscopically through a few small openings in the skin to allow a camera and surgical instruments to be inserted into the shoulder. Using sutures and ties the tendons of the cuff can be anchored back onto the bone and stability is recovered. This surgery is done outpatient, and most patients go home the same day.
The day of rotator cuff surgery, a bandage is placed over the stitches and you will be given a sling. This sling is worn for 6 weeks. Rotator cuff rehab involves physical therapy that begins 1 month after surgery and focuses initially only on range of motion. Starting at 12 weeks, if patients have achieved good range of motion, we begin gentle strengthening. The timeframe for recovery from rotator cuff repair can be longer than most other surgeries, however most patients are better by 6 months.
If you are in need of rotator cuff repair, trust the experience and knowledge of Dr. Dorf. He has performed over 10,000 operative procedures and can help you find a treatment option that works for you. Request a consultation now.