The rotator cuff is a group of muscle and tendon that surround the shoulder joint. In a complex and coordinated manner, it stabilises and ensures a smooth function of the shoulder joint. A rotator cuff tear can be caused by an acute injury, such as a fall or by normal age-related wear and tear leading to the degeneration of the tendon.
A rotator cuff tear can cause pain in the front of the shoulder, which radiates down the side of the arm. The pain is felt with overreaching, with overhead activities and with lying on the side during sleep. There is associated weakness and difficulty with routine activities such as brushing the hair or reaching behind the back.
Potential complications such as a permanent loss of function, weakness and progressive degeneration can occur. The diagnosis can be made with a combination of clinical examination and imaging studies. An ultrasound scan can provide dynamic testing, while an MRI scan provides a more detailed review of the structures in the shoulder and allows preoperative planning.
The treatment of a rotator cuff tear includes conservative and operative. The aim of conservative management is to manage the pain by avoiding aggravating factors through activity modification and to maintain the shoulder range of motion and peri-scapular muscle strength.
Studies have shown that a rotator cuff tear does not heal on its own. If progressive pain or weakness develops, this may indicate the tear is getting larger. Surgical repair would be the most effective method to restore strength and eliminate pain. This can be achieved with a mini-open or an arthroscopic surgery.
The results of the surgery are most effective with a simple post-operative rehabilitation program, while the patient’s motivation and dedication are important in this partnership.