What is a rotator cuff?
The shoulder’s rotator cuff consists of four muscles and tendons that allow the humeral head (the “ball”) to rotate against the glenoid (the “socket”). Rotator cuff tears occur when the rotator cuff tendon pulls away from the humerus, the long bone in the arm that runs from the shoulder to the elbow.
Rotator cuff injuries range from tendinitis to partial tearing to full-thickness tearing. Rotator cuff tears most commonly involve the top rotator cuff tendon, called the supraspinatus, but any or all of the rotator cuff’s four tendons may be torn.
What causes rotator cuff tears?
Rotator cuff tears can result from shoulder dislocation, a fall, chronic overuse and/or tendon degeneration (“wear and tear”).
What are the symptoms of rotator cuff tears?
- Pain with daily activities, such as lifting the arm, carrying an object or lying on the shoulder
- Pain with job or recreational activities
- Loss of shoulder strength
- Loss of shoulder motion
Pain at night that makes it hard to sleep or causes you to wake up from sleep is a common complaint among patients with a rotator cuff tear. In patients with large rotator cuff tears, the shoulder may become dramatically weaker, and/or you could be completely unable to lift your arm.
How is a rotator cuff tear diagnosed?
Diagnosing a rotator cuff tear begins with a physician listening to your symptoms and gathering a detailed medical history and physical examination. This includes identifying areas and types of pain, assessing your range of motion and assessing the rotator cuff’s strength.
X-rays are taken and, often, magnetic resonance imaging (MRI) is needed to confirm the diagnosis of rotator cuff tear to determine the size and pattern of tearing.
How is a rotator cuff tear treated?
Most people who have rotator cuff tears don’t need surgery to relieve pain, improve motion, improve shoulder function and regain the functions of work, play and daily life. Nonsurgical treatment includes rest, ice, heat, anti-inflammatory medication and physical therapy, all of which reduce pain and inflammation and allow the uninjured rotator cuff to compensate for the tear. Cortisone injections are sometimes used for additional pain relief.
If surgery is needed or if nonsurgical options fail, surgeons at The Ohio State University Wexner Medical Center can perform minimally invasive arthroscopic repair using a camera and small incisions. This procedure may result in less pain and a faster return to daily activities.
The recovery process for rotator cuff repair surgery includes wearing a sling for about six weeks and beginning physical therapy shortly after surgery to keep the shoulder from becoming stiff. Physical therapy involves implementing progressively more independent movements for about six months after surgery. Some patients who have larger, more serious tears may take up to nine months or a year to regain a full range of motion in their shoulder.
In rare cases in which a tear is too advanced for a full repair to be performed, the Ohio State Wexner Medical Center can provide options for irreparable rotator cuff tear, including joint-preserving treatments such as superior capsular reconstruction.
Why choose Ohio State for rotator cuff repair?
The Ohio State University Wexner Medical Center specializes in the most advanced treatment options available for rotator cuff tears. We have a team of orthopedic and sports medicine experts who work solely with the shoulder, including anesthesiologists, physical therapists, surgeons and other health care providers who are dedicated to treating shoulder issues with a focus on minimized risk and pain and fast recovery.
Orthopedic experts at Ohio State also lead medical research to improve shoulder treatments and determine more specific causes for injuries. This includes participating in one of the largest research projects in the country to study when surgery is needed for rotator cuff tears and when patients could do well using only nonsurgical treatment options.
