Rotator Cuff Tears

Written by admin on January 22, 2013 – 8:24 am -

Your shoulder hurts, but you cannot remember an injury. You are unsure of exactly when and how it began. It wakes you every night and may hurt with many routine daily activities. Sports are no longer possible. Huh?! What happened?

If you’re over the age of 40, your rotator cuff may be beginning to fail, causing discomfort and diminished function. The incidence of rotator cuff tears increases with age, and a specific injury is not required. The rotator cuff is comprised of four small muscles, the supraspinatus, infraspinatus, subscapularis and teres minor. These muscles are responsible for proper motion and stability of the shoulder joint.

Aging and repetitive use often results in weakening of the tendon which detaches from insertion point on the humerus. The process occurs in much in the same way as a blanket becomes threadbare or a rope begins to fray. Over head athletes and those of us with jobs requiring repetitive overhead motion are more susceptible to rotator cuff pathologies.

Symptoms of rotator cuff insufficiency include: achy pain at rest and particularly at night, pain with over head motion or reaching behind the body. Progressively worsening and more frequent pain is also a typical progression of rotator cuff pathology. An orthopedic surgeon specializing in shoulder conditions can help accurately diagnose a rotator cuff tear and initiate appropriate treatment. On occasion more extensive testing such as ultrasound or MRI may be required to better evaluate the condition of the rotator cuff tendons. Results of these examinations will help to determine the most appropriate treatment.

Recommendations may include activity modification (avoid activities that cause pain), physical therapy with elastic bands to strengthen the muscles, oral or topical anti-inflammatory medication, and steroid injections in the shoulder. This treatment will not necessarily reverse the damage, but rather will improve function of the muscles to lessen the daily wear on the remaining tendons, if successful, some healing of the damaged tendons may occur.

If symptoms persist after six weeks of diligent rehab and compliance with conservative treatment plan, more aggressive treatment, such as surgery, may be required. The surgical technique is intended to remove any damaged tendon that lacks adequate blood supply (and thus, is unable to heal) and to repair the viable, healthy tendon attaching it back to the bone. The procedure is arthroscopic (2-4 small incisions), outpatient, and usually performed without the need for general anesthesia. Return to daily living activities usually requires 2-6 weeks. Full recovery can be long and arduous, but excellent results are achieved more than 80% of the time.

Shoulder pain is never something to ignore, and should be evaluated by an orthopedic shoulder specialist to insure the proper course of treatment.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com or you can follow him on twitter: @drmarkgalland.

Kate Anderson, LAT, ATC is a post-graduate fellow at GOSM, Galland Orthopaedic and Sports Medicine. Follow her on twitter @kattethegreatt.


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