Introduction
Rotator cuff tear is a typical problem of the rotator cuff muscles of the shoulder.
The rotator cuff is a group of tendons that connects the four muscles of the upper shoulder to the bones. The muscles are referred to as the ‘SITS’ muscles .i.e. supraspinatus, infraspinatus, teres minor and subcapularis. This group of muscles is frequently injured by tears, tendonitis, impingement, bursitis and strains.
Incidence
Rotator cuff tears usually occur in people who have had rotator cuff tendonitis for a while are starting to experience more weakness. This condition might also occur in people who try to lift something very heavy and feel a sudden pop in their shoulder.
The incidence of rotator cuff increases dramatically with age. The condition is more popular in the dominant arm and can be present in the opposite shoulder even if there is no pain.
Symptoms of Rotator Cuff Tear
The condition of rotator cuff tear is generally accompanied by the following symptoms:
• Pain, located primarily on the top and in the front of the shoulder
• Weakness, especially worsening with overhead activity
• Stiffness in the shoulder
• Loss of motion
• Popping or a crackling sensation in the shoulder
• Inability to sleep on the shoulder
Causative Factors
A rotator cuff tear might be caused by a number of reasons. Here we list some of the most common causes:
• Injury, especially while trying to lift or catch a heavy object
• Overuse, especially after a period of inactivity
• Poor blood supply to an area of the cuff
• A fall on an outstretched arm
• A gradual weakening of the tendons of the shoulder, associated with impingement
Diagnosis
Prompt diagnosis of a rotator cuff tear can have profound effect on the treatment. Diagnosis of a rotator cuff tear is made using special tests as well as through an examination to check the motion for any stiffness.
Normally, an x-ray will show bone spurs in people with rotator cuff tears. These bone spurs usually help to create the tear.
At times, an MRI is recommended to indicate the area where the rotator cuff tendon is torn. An MR-arthrogram might be ordered, which involves an injection into the shoulder before the regular MRI.
Treatment Options
The treatment plan for a rotator cuff tear is devised with the following goals in view:
• To control pain
• To regain motion
• To strengthen unaffected muscles
There are two basic forms of treatment available in the condition of rotator cuff tear .i.e. Non-operative and Operative. Here we briefly explain each one of them.
A) Non-operative
• Physical therapy
• Anti-inflammatory medicines
• Cortisone injections
B) Operative
Several surgical procedures are possible for treatment of rotator cuff tear. These include:
• Open repair
• Mini-open repair
• Arthroscopic repair
