Sports Medicine - Shoulder


Rotator Cuff Injuries

 

Definition:

The rotator cuff is a set of four muscles connected to the humerus bone which help stabilize the shoulder as well as move the upper arm. Through either a specific injury (eg. a fall onto the arm or shoulder) or through repetitive shoulder motion (eg. throwing, playing racquet sports), the rotator cuff can become inflamed and sustain actual damage. In some instances (eg. a severe fall onto the arm or shoulder) the rotator cuff can completely tear off its connection to the humerus bone. When this occurs there is pain in the shoulder region accompanied by an inability to raise the arm. When this occurs, the rotator cuff is usually repaired surgically, once again allowing active motion of the shoulder. The rotator cuff can also sustain partial tears. Partial tears may be painful, but usually can be treated with medications and physical therapy.

Diagnosis:

Rotator cuff injuries are diagnosed by taking a careful history, performing a physical exam of the shoulder, supplemented by diagnostic imaging. Plain x-rays may be helpful in the diagnosis of rotator cuff injuries. Additional tests that may help your physician determine the integrity of the rotator cuff include an arthrogram (x-rays utilizing dye injected into the shoulder) or an MRI scan. An MRI can usually distinguish a partial from a complete tear.

Treatment Options:

Treatment ranges from physical therapy and medications for small or partial tear to surgery, either arthroscopic or open surgery, depending on the diagnosis. If surgery is needed, arthroscopic surgery can be performed on an outpatient basis while open surgery may require an overnight stay in the hospital. Physical therapy is usually started within days to 2 weeks after surgery, depending on the type of surgery. Surgery can restore normal function to the shoulder joint after repair of the rotator cuff.



 

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