PATIENT
EDUCATION

Symptoms

• Tender, sore shoulder during shoulder activity
• Difficulty raising the arm above the head
• Pain at night in the affected shoulder

What Is a Rotator Cuff Tear?

The rotator cuff is a group of tendons and muscles that are around the shoulder joint which keeps the upper arm within the socket of the shoulder. An injury to these muscles and tendons may result in a dull ache in the shoulder, which may worsen during the night when you sleep on the injured side. These injuries occur most often in people who repeatedly perform overhead-type motions in sports or their jobs. The risk of such an injury also increases with age. A rotator cuff tear is seen both in the young and old, but they are much more common in the older population. Usually in younger patients, there is either a traumatic injury or the patient is demanding unusual use of their shoulder, as seen in professional athletes.

Not every rotator cuff tear causes significant pain or disability. In fact, autopsy studies have shown rotator cuff tears in up to 70% of people over the age of 80 and 30% of the population under the age of 70. However, in many individuals, a rotator cuff tear can cause significant disability, and prompt diagnosis and treatment can result in a profound improvement in symptoms.

Nonsurgical Treatment

Many people can recover from a rotator cuff injury with conservative treatment options, such as physical therapy, which improves the flexibility and strength of those muscles. Other forms of conservative treatment, such as anti-inflammatories, injections, or rest, may also help. More severe tears may require surgical treatment.

Surgical Treatments

Minimally Invasive Arthroscopic Rotator Cuff Repair
There have been numerous advances in surgical options for rotator cuff tears over the past 10 years. Most repairs can now be performed arthroscopically. This is referred to as the “arthroscopic rotator cuff repair.” Instead of making a larger incision and looking directly at the rotator cuff, the surgeon makes several small incisions (about 1 centimeter each) and works with small instruments while looking at the rotator cuff on a television monitor. Many members of our exceptional team of orthopaedic surgeons, including Dr. Tuvi Mendel, perform arthroscopic rotator cuff repair surgery as a minimally invasive method of reattaching the torn rotator cuff tendon to the humeral head.

This advance allows surgeons to minimize the problems associated with an operation. With a traditional open rotator cuff repair, the surgical dissection can potentially cause pain and disability despite a good rotator cuff repair. This technique results in smaller incisions, less scarring, less pain, and faster recovery than for the open surgical procedure. This method reduces and minimizes postoperative pain and allows the procedure to be performed on an outpatient basis.

Traditional Open Rotator Cuff Repair Surgery
Traditionally, when a patient sustained a rotator cuff tear that required surgical repair, an incision was made over the outside of the shoulder, usually about 6 – 10 centimeters in length. The muscle beneath the skin was separated to expose the rotator cuff, and the rotator cuff was then inspected and repaired. This is what surgeons call an “open rotator cuff repair.”

Unfortunately, this surgical dissection causes significant pain and can be a persistent problem even after the rotator cuff tear has healed. However, this method is used when the arthroscopic technique alone is unable to address the problems, such as in large retracted cuff tears.