There’s no doubt that the muscles in our bodies are tough. They have to withstand stress and injury and overuse, hopefully not all at the same time, and they must bounce back quickly so we can continue with our activities. But every muscle has its limit, and sometimes that limit is achieved with the onset of intense pain or sudden loss of motion.
One muscle group that bears the brunt of such use is the rotator cuff. The rotator cuff is actually four muscles that come together to form a tendon that covers the ball of the shoulder. Its purpose is to keep the upper arm bone firmly secured in the joint. It also assists with movements such as raising your arm and positioning your hand away from your body.
The rotator cuff can be damaged from an acute injury or from degeneration as we age. The traumatic tears are usually from falls on an outstretched arm or from an abrupt movement, such as pulling the cord to start a mower. The symptoms usually include pain at night, weakness when raising your arm away from your body, and sometimes popping. These tears can be complete or partial. Partial tears are treated with rest, injections, physical therapy, and sometimes surgery. Most complete tears are treated with surgery.
Non-traumatic tears occur as a result of repetitive overhead use, chronic rubbing by a bone spur, or tendon degeneration as a result of poor blood supply. Treatment from non-traumatic tears is usually conservative with rest, exercises, and injections. Surgery is only indicated if the patient fails prolonged course or conservative care. The quality of the tissue determines whether surgery will happen.
If the tissue is in good condition, and there is no wasting of the muscle, then a surgical repair can be performed. Biologic patches have been introduced that can be used to supplement if the tissue is thin or inadequate. The tissue is stapled in place to cover the torn muscle and within weeks, the patient’s own fibers and tendons have begun growing into the transplanted tissue to heal the tear. If the tissue is poor or the muscle is wasted, then a reverse shoulder replacement may be the only option to restore function.
Rehabbing a rotator cuff repair means immobilization for the first few weeks while the tendon begins to repair itself. Physical therapy comes next after healing has taken place and the muscles can begin to withstand exercise to improve range of motion. A complete recovery can take several months. Each patient is different and your doctor will work with you on the best course of treatment for your injury.
Read more about how we treat rotator cuffs!