When is a Rotator Cuff Repair Needed?
A rotator cuff tear is one of the most common problems affecting the shoulder. It is most commonly seen in patients over the age of 40. It usually does not occur as the result of one, particular injury. Rather, rotator cuff tendons more often tear over time as a result of “wear and tear.”
The rotator cuff is comprised of 4 muscles and their associated tendons that act together to move and power the shoulder. Common conditions that affect the rotator cuff include:
- Rotator Cuff Tendonitis and Associated Subacromial Bursitis: inflammation of the rotator cuff tendons and the overlying bursa sac is usually caused by chronic, repetitive overhead work or overhead sports.
- Rotator Cuff Tendon Tearing: The wide range of shoulder motion that the rotator cuff facilitates as well as the high forces that the tendons are subjected to with overhead lifting or overhead sports makes them susceptible to tear over time. Most tears are the result of this “wear and tear.” Less commonly, rotator cuff tears occur as the result of an acute injury or fall. When a rotator cuff tendon tears, it partially or completely pulls away from its normal attachment site on the top of the humerus bone.
Rotator cuff tendonitis, subacromial bursitis and low grade, partial thickness rotator cuff tears are all initially treated with non-surgical methods. These treatments include physical therapy, which focuses on rotator cuff strengthening exercises, anti-inflammatory medications, and injections if needed. When the rotator cuff muscles are strong, the humeral head is held down in the center of the shoulder socket and the rotator cuff tendons are then less likely to be impinged and inflamed when doing overhead activities.
If there is complete tearing of one or more of the rotator cuff tendons away from their normal bone attachment site, these tears will not heal without surgery. If there is a full thickness tear and if you are experiencing pain and weakness as a result, then arthroscopic rotator cuff repair surgery is reasonable to undergo. In rotator cuff surgery, the torn tendons are freed up from scar tissue, mobilized, and then reattached back to their normal attachment sites on the humerus. The repair is protected and over time the tendons will grow back into the bone. As a result of this healing, one can regain full shoulder motion and strength and resume activities that they could not previously do without severe pain and weakness. Rotator cuff repair surgery is a common procedure that has high levels of patient satisfaction.