Introduction
What is a rotator cuff?
Within the shoulder are four muscle/tendons which cover the top part of the upper arm bone (humerus). The rotator cuff allows the shoulder to have a large range of mobility, while keeping the head of the humerus securely in place in the shallow socket of the shoulder (glenoid). This muscle/tendon grouping attaches the shoulder blade and the humerus to the shoulder, allowing the arm to rotate, bend, stretch and lift. The stability of the shoulder is aided, primarily by the rotator cuff. Doctor Frank McCormick, orthopedic shoulder specialist serving Orlando, Kissimmee, West Palm Beach County, Florid and the surrounding areas is extremely skilled at diagnosing and treating rotator cuff injuries, with the goal of returning patients to their pre-injury lifestyle.
What is a rotator cuff injury?
Rotator cuff injuries are most often caused by overuse and are seen in older individuals and athletes competing in overhead sports such as basketball, baseball, tennis, and swimming. Athletes have a high percentage of rotator cuff injury, as much as 21%. Rotator cuff injuries occur when one or more of the tendons that make up the rotator cuff become damaged and tear away from the upper arm bone, or humerus. Rotator cuff injuries can vary from slight fraying to a complete tendon tear.
What are the types of rotator cuff tears?
Rotator cuff injuries or tears are classified by how much of the tendon/muscle group is damaged and the cause of the tear:
- Partial Tear: One or more of the tendons of the rotator cuff are damaged, but not completely severed.
- Complete Tear: The tendon is completely severed in 2 pieces or have completely torn off of their attachment on the humerus.
- Acute Tear: a partial or complete tear caused by trauma, such as a hard fall, or from lifting something very heavy.
- Degenerative Tear: A gradual wearing away of the tendon, over time as seen in older individuals, or athletes in sports that require repetitive overhead motions.
What are the symptoms of a rotator cuff injury?
The primary symptom of a rotator cuff injury is pain. Other symptoms may include:
- Night pain, especially if sleeping on the affected shoulder
- Cracking or popping with arm rotation or movement
- Inability to lift and lower the arm without pain
- Decreased range of motion
- Loss of strength in the affected arm and shoulder
How do you know if you’ve injured your rotator cuff?
Dr. McCormick will obtain a thorough medical history and discuss events leading up to symptoms the patient is experiencing. He will then conduct a thorough examination, checking for range of motion, pain and arm strength. An x-ray will show any bone deformities or abnormalities and an MRI will help confirm the diagnosis as well as the degree of damage to the rotator cuff.
What is the treatment for a rotator cuff injury?
Non-surgical treatment:
For slight tearing or a rotator cuff strain, non-surgical treatment may include:
- RICE: Rest, Ice, Compression, Elevation
Activity modification to allow healing - NSAIDs (Non-steroidal anti-inflammatory drugs)
- Corticosteroid injections
- Physical Therapy
Surgical treatment:
For complete tears, or if non-surgical treatment has failed to restore function and eliminate pain, Dr. McCormick may suggest surgical treatment. Severe or complete rotator cuff tears will need a rotator cuff repair to reattach the tendon to the bone. This is often done arthroscopically, using a small camera (arthroscope) which is inserted through a small incision in the shoulder and allows Dr. McCormick to visualize the shoulder structures on a screen. Small surgical instruments are then used to make the repairs within the shoulder with sutures and/or specialized anchors or screws. Arthroscopic shoulder surgery allows a quicker healing time, less chance for infection and less post-operative pain.
For more information on rotator cuff injuries, or the treatment options available for your shoulder pain, please contact the office of Frank McCormick, MD, orthopedic shoulder specialist serving Orlando, Kissimmee, West Palm Beach County, Florida and the surrounding areas.
