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Rotator Cuff Facts

Of the major joints of the human body, the shoulder may be the most at risk for injury. Approximately six million people in the United States visit a physician each year due to some type of shoulder problem. The shoulder moves through a greater range of motion than any other joint in the body and its amazing flexibility makes our shoulders so versatile, yet so unstable. When your shoulder is injured, your normal lifestyle suffers. Driving a car, pitching a baseball, or doing chores around the house, almost any activity requires use of the shoulder. For this reason, the rotator cuff can be damaged throughout your lifetime, sometimes to the point where surgery is needed.

The rotator cuff is a group of four tendons that help stabilize and move the shoulder. A tear of the rotator cuff can occur in many ways, and no two rotator cuff tears are the same. Treatment is based on many factors, including how long the tear has been present, size of the tear, activity level of the patient, and medical condition of the patient. Therefore, we tailor the treatment of the rotator cuff tear to each individual.

A rotator cuff tear can be suspected based on a patient’s history. Patients frequently complain of shoulder pain that wakes them from sleep. This pain is not usually felt in the shoulder blade or neck but in the upper arm area. Patients often have pain or difficulty with overhead activities, activities behind the back (such as fastening a bra), and activities away from the body (such as getting a gallon of milk out of the refrigerator). In severe cases the patient might be unable to reach overhead at all.

The diagnosis can also be suspected based on a physical examination performed by your physician. Other diagnoses can act like a rotator cuff tear, such as tendonitis and bursitis and even a frozen shoulder. This is why a physical examination is important and why your physician might order an MRI. An MRI is a special study that evaluates the soft tissue and bone within the shoulder without the use of X-ray’s.

The goal of the surgery is to repair the rotator cuff tendons back to the bone. We do most of these surgeries arthroscopically. However, if the tear is large or the tissue is questionable, an open rotator cuff repair may be necessary.

An arthroscopic rotator cuff repair is an outpatient procedure. The repair is performed through small portals. Anchors, which are small screws that are placed in the bone, have suture attached to them. The sutures are passed through the rotator cuff tendons and then tied down, securing the rotator cuff back to the bone. An open rotator cuff repair is reserved for large tears when extra fixation is necessary.

The rehabilitation is basically the same for open and arthroscopic rotator cuff repairs. Please refer to the Shoulder and Elbow Center section of our website at www.kocortho.com for more information about rotator cuff repair rehabilitation and other injuries concerning the shoulder and elbow.

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