A rotator cuff tear is a common cause of pain and disability among adults. A fall or traumatic injury may cause a rotator cuff tear as well as deterioration of the tendons over time. A torn rotator cuff will weaken your shoulder. This results in pain for many everyday activities, such as brushing your hair or getting dressed.
The goal of treating rotator cuff tears is to reduce pain and restore function.
What is the rotator cuff?
The rotator cuff is a group of four muscles (subscapularis, supraspinatus, infraspinatus and teres minor) that come together as tendons to form a covering around the head of the humerus (shoulder ball). The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm. Net, the rotator cuff muscles are responsible for shoulder rotation and form a cuff around the head of the humerus (shoulder ball).
Rotator cuff injuries
A sudden fall, accident or heavy lifting may cause a tear to the rotator cuff. There may be a snapping sensation and immediate weakness in the upper arm, indicating a tear has occurred. More common, however, is degeneration of the tendon that happens as we age. This general, slow wear and tear of the rotator cuff causes pain in everyday movement.
Types of rotator cuff injuries
Several types of rotator cuff injuries exist. Some of the most common injuries are:
Rotator cuff tendonitis – Rotator cuff tendonitis is inflammation of one or more of the rotator cuff tendons.
Biceps tendonitis – The long head of the biceps is located within the shoulder and has a tremendous amount of nerve fibers and is a common source of soreness and pain.
Shoulder impingement syndrome – Shoulder impingement syndrome occurs when the rotator cuff tendons are intermittently trapped and compressed during shoulder movements.
Partial rotator cuff tear – When the tendon is still attached but some fraying or tear is noticed, partial rotator cuff tear has occurred.
Full rotator cuff tear – In a full rotator cuff tear, the tendon is torn from the attachment site at the bone.
Frozen Shoulder –Inflammation or injury in the shoulder causes the shoulder to lose the normal range of motion.
Rotator Cuff treatment
When possible, the first treatment option is non-surgical. Your orthopedic may suggest physical therapy, over the counter anti-inflammatories or injections. If these methods have not reduced pain, surgery may be the best road to recovery.
Depending on your injury, activity goals, medical history and pain, your orthopedic surgeon will determine the best surgical treatment. In most cases, surgery is performed on an outpatient basis through the arthroscope. Some shoulder procedures include arthroscopic rotator cuff repair, biceps tenodesis (disconnect and reconnect of the tendon) and removal of bone spurs within the shoulder.
The recovery timeline from surgery varies by the individual. A typical road map to wellness has several phases with full release 12 to 24 weeks after surgery.
Shoulder Surgery Rehab: JPL in Lee’s Summit, KS and Overland Park, MO
At Advanced Orthopedics & Sports Medicine, patients recovering from shoulder surgery will follow a rehab protocol called the JPL rehab program. There are 4 key phases to full recovery:
Phase 1 – Patients start JPL exercise program on the third day post-surgery. Patients continue using JPL 3 to 5 times a day. Outside of therapy, a sling is worn full-time.
Phase 2 – Physical therapy starts on week 2 and may continue for 6 weeks, depending on the patient. The focus in weeks 2 – 8 is to achieve full range of motion. Patients typically discontinue use of the sling around week 4 or 5.
Phase 3 – During weeks 8 to 12, patients maximize range of motion. Progressive strengthening begins.
Phase 4 – Three to four months post-surgery, patients typically resume normal activities. Many will need to continue strengthening their shoulder.
Some of the risks of rotator cuff surgery include infection, graft site pain, blood clot, hardware issues, re-rupture and risks associated with anesthesia.
Read more about JPL Shoulder Rehab.
If you think you have a rotator cuff injury and are seeking treatment, schedule an appointment with one of our specialists at Advanced Orthopedics & Sports Medicine.