What is the Rotator Cuff?
The shoulder is a very complex joint; it is also the most mobile joint in the body. The mobility in the shoulder occurs because the joint is not held together by the bones,rather the muscles, tendons, and ligaments hold the shoulder joint together. While this allows the mobility we need, it also puts the shoulder at risk of injury. The shoulder joint is somewhat like a “golf ball” (Humeral Head) and a “golf tee” (Glenoid of the Scapula). The ball is very large and the tee surface is not very large. The rotator cuff is the group of 4 muscles in the shoulder that form a “cuff” around the ball. The rotator cuff muscles and tendons are responsible for keeping the “golf ball on the tee.”
What Can Cause a Rotator Cuff Tear?
Shoulder motions that are used during activities such as golf, pitching, or lifting and/or carrying heavy items can cause repetitive stress in the rotator cuff that leads to irritation, bruising, or fraying. This may lead to pain or weakness.
When the space between the acromion and the rotator cuff is narrowed, the bone pinches the cuff and causes irritation. Weakness, a swollen bursa, or a naturally occurring shape of the acromion can cause this irritation. This may result in pain, weakness, or loss of motion.
Sometimes prolonged inflammation can lead to buildup of calcium within the rotator cuff. This may result in pain and loss of strength and motion.
What are the Symptoms of a Rotator Cuff Tear?
Severe tendonitis from impingement degeneration, or a sudden injury like a fall, can cause partial or complete tearing of the rotator cuff. This may result in pain, weakness and/or loss of motion.
Signs and Symptoms
- Pain with overhead activities
- Pain with throwing
- Pain while sleeping
- Pain or difficulty putting on a jacket or coat
- Pain with pouring a glass of milk
- Pain at night
- Weakness in your shoulder
How do you Diagnosis a Rotator Cuff Tear
Your doctor will get your medical history and the story of your problem. This combined with the examination will help the doctor decide what tests to order. Some of the tests are as follows:
- X-rays show bony structures and will reveal any abnormalities.
- An arthrogram is a special x-ray that uses dye that is injected into your shoulder and helps determine if the rotator cuff is torn.
- An MRI , (magnetic resonance imaging) which is a more sophisticated test that reveals all the structures in your shoulder.
Non Surgical Rotator Cuff Tear Treatments
Your doctor may feel that you would benefit from anti-inflammatory medication, and/or physical therapy. In therapy your rehabilitation specialist will work on pain control, range of motion, and strength. You can use ice to help with the pain that you have when you are home. You can use a cold pack, ice bag, or a bag of frozen peas for 15-20 minutes at a time.
Surgical Treatment for Rotator Cuff Tears
If conservative treatments fail to relieve your pain and improve your shoulders function than a surgical option maybe discussed.
Arthroscopic shoudler surgery can be performed under general anesthesia sometimes with an additional regional anesthesia. Regional anesthesia, often referred to as a block, numbs your shoulder and arm, and general anesthesia puts you to sleep. The anesthesiologist will help you determine which would be the best for you.
Dr. Gambacorta will make a few small incisions around your shoulder. A sterile solution will be used to fill the shoulder joint and rinse away any cloudy fluid, providing a clear view of your shoulder.
Dr. Gambacorta will then insert the arthroscope to properly diagnose your problem, using the TV image to guide the arthroscope. He may use a variety of small surgical instruments (e.g., scissors, clamps, motorized shavers) through another small incision to remove or repair the torn cartilage, bursal tissue or extra bone spurs. Dr. Gambacorta can also repair torn tendons of the rotator cuff and labral cartilage. This part of the procedure usually lasts 1-2 hours.
At the conclusion of your surgery, Dr. Gambacorta will close your incisions with sutures and cover them with a bandage. You will be moved to the recovery room. Usually, you will be ready to go home in one or two hours. You should have someone with you to drive you home
If you are unsure what type of pain you are experiencing and would like to schedule a consultation appointment with
contact us at (716) 636-1470.
For more information on this and other injuries see our website at www.northtownsorthopedics.com.
This information is intended for education of the reader about medical conditions and current treatments. It is not a substitute for examination, diagnosis, and care provided by your physician or a licensed healthcare provider. If you believe that you, your child, or someone you know has the condition described herein, please see your healthcare provider. Do not attempt to treat yourself or anyone else without proper medical attention.