The diagram to the right illustrates how surgical intervention can repair a torn rotator cuff.
The shoulder is a ball-and-socket joint: the top of the humerus (upper arm bone) forms the ball and the edge of the scapula (shoulder blade), called the glenoid cavity, creates the socket. The humerus attaches to the scapula by the rotator cuff muscles. There are four muscles that make up the rotator cuff which allow you to lift and rotate your arm.
When there is a torn rotator cuff muscle, it is either partially torn or the tendon(s) have been completely severed from the humerus bone. Rotator cuff tears result from either an acute injury or degeneration over time. Both types of tears are often associated with overhead and lifting motions. In patients over the age of 40, shoulder pain is often the result of a torn rotator cuff.
- Acute Injury: acute tears occur with a significant fall or trying to lift an object that is too heavy. They are often associated with other shoulder injuries such as dislocation or a broken collarbone.
- Degeneration: degeneration is the most common cause rotator cuff tears. They are the result of slight fraying of the tendon over time due to repetitive stress. The risk of rotator cuff tears increases with age.
Rotator cuff injuries and tears are commonly seen in baseball players, tennis players, rowers, weightlifters, construction workers, and carpenters.
Symptoms:
- Weakness
- Loss of or limited range of motion
- Dull, achy pain
- Cracking with certain movements
- Swelling
- Pain with:
- Resistance
- Reaching
- Lifting everyday objects
- Lifting or lowering the arm
- Sleeping on affected side
If your symptoms last longer than 2 weeks and interfere with daily activity you should consult your primary care physician for a referral.
What To Expect During Your Appointment:
During your appointment, Dr. Betz will perform a physical exam to test range of motion in the shoulder and the arm strength. In-office imaging may be done or an MRI may be set up to diagnose the cause of your pain. Once the results of your imaging come back, Dr. Betz will provide treatment options and help you decide the course of action that is best for you.
Treatment
Dr. Betz performs an in-office exam on the patient to check for range of motion and arm strength.
Non-Surgical Options:
- Rest
- Medication: non-steroidal anti-inflammatories are often prescribed to minimize swelling and pain.
- Physical Therapy: strengthening the shoulder muscles will help relieve pain and prevent further injury. Stretching is also performed to help regain mobility.
- Injections: If the other non-surgical treatments fail, Dr. Betz can use injections to help reduce pain.
- Steroid Injection (Cortisone): steroids are proven to be very effective at reducing inflammation and pain when injected directly into the joint space.
- Platelet Rich Plasma (PRP): your own blood is used to extract platelet-rich plasma, which is then injected into the shoulder joint. The platelets within the plasma stimulate the body to repair itself.
Surgical Options:
If non-surgical treatments fail to improve pain, Dr. Betz will discuss surgery as an option. Each patient and tear is different, but most tears can be treated arthroscopically. For more information on arthroscopic surgery please see “Arthroscopic Surgery”.
For postoperative patients: