Rotator Cuff Tear

Overview

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Rotator Cuff is formed by the 4 small muscles which run between the shoulder blade (scapula) and the arm bone (humerus). They form a covering layer for the shoulder joint. While the outer muscles perform the big lever arm movements, the fine tuning of these movements is done by the rotator cuff muscles. Out of these 4 muscles supraspinatus is the muscle which sits between the roof bone (acromion) and the ball of the arm bone (head of the humerus). This muscle is more prone for injuries. 

 

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Why & how does it happen?

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Rotator cuff tear can happen due to acute injury such as fall on to the shoulder. Other common mode of tear is due to repetitve strain injury. People with the roof bone (acromion) being curved downwards are more likely to end up having the rotator cuff tear. 

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Who gets this injury?

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We see this in 2 different age groups.

 

typically in sporting population such as footballers, basketball players, cricketers, badminton and so on. Fall from the two wheelers, bikes and cycles are another common reason for this injury. Typical age group is 20 to 45 years.

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Symptoms

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• Gradual onset of pain

• Restricted range of movement

• Clicking sounds

• Painful to sleep on the affected side

• Pain often felt the arm area and not in the shoulder joint area

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When to seek medical help?

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Initial assessment, an x-ray and pain relieving medicines form first line of management. Further assessment by an expert Arthroscopy Surgeon and MRI scan are necessary to analyze the extent of injury.

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What happens to the rotator cuff tear if no treatment is undertaken?

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Rotator cuff tear gradually worsens over a period of several months to years. A partial tear may worsen to become a complete tear. A complete tear of the rotator cuff leads to the muscle becoming atrophied (shrivelled) and of no use over a period of 12 to 18 months. As the joint congruity and support is lost the joint becomes arthritic due to increased wear and tear. This condition is called rotator cuff arthropathy. It develops over a period of few years. Once the joint becomes arthritic, the pain will become constant.

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What happens when I visit the Consultant?

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You will be asked about the nature of injury, symptoms further to that so far. Consultant will examine you and discuss the treatment modalities. 

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What treatment options do we have?

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The treatment modalities vary from physiotherapy to PRP Injection to arthroscopic rotator cuff repair depending on the type of tear, severity and chronicity of the tear.