Rotator Cuff Tears
The shoulder joint is described as a “ball and socket.” The shoulder is made up of three bones. The “ball” component is made up of the head of the humerus (upper arm bone). The “socket” component, called the glenoid, is made up of the outer portion of the scapula, commonly called the shoulder blade. The third bone is the clavicle or collarbone. The labrum is a rim of cartilage on the socket that helps stabilize the joint. The stability of the shoulder joint mainly depends on the capsule, a strong envelope tissue surrounding the joint, ligaments connecting bones in the shoulder joint, tendons that attach muscles to bones, and the muscles themselves which initiate and control the position and activity of the joint. Contributing to stability of the shoulder is the rotator cuff. The cuff formed of tendons attaches to the humerus and their four major muscles, which drape over the shoulder joint. The large muscles, which attach to the scapula (shoulder blade), play a significant role in the normal function of the shoulder.
Causes and risk factors
- Direct blow, fall, or sports related injury
- Degenerative conditions such as arthritis
- Repetitive stress, often from sports such as baseball, tennis, or weightlifting.
- Bone spurs
- Shoulder pain can be constant or when you are at rest
- Pain or weakness when lifting or lowering your arm
- Limited range of motion
- Clicking or popping
Diagnosis and Treatment
Non-surgical treatments include anti-inflammatory medications, rest, ice, corticosteroid injections, and/or physical therapy. Surgical repair may be an option, depending on the severity of the injury. Your orthopedic surgeon may recommend surgery to repair a torn rotator cuff if your symptoms don’t go away after conservative treatment, you have a large tear (more than 3cm), or if it was caused by a recent trauma.
There are advantages and disadvantages to the several surgical options to discuss with your doctor, who will recommend the appropriate one according to your injury. An open repair involves an incision over the shoulder and detaches the shoulder muscle (deltoid) to gain access to the torn rotator cuff. Arthroscopic surgery can also be used to repair the tendon. During this minimally invasive procedure, your surgeon will make small incisions in your shoulder and insert a small camera and surgical instruments in your shoulder to repair the torn tendon.