Rotator Cuff

The rotator cuff is a group of four muscles and their tendons that wrap around the top of the shoulder joint.

These four major muscels (supraspinatus, infraspinatus, subscapularis, teres minor) and their tendons connect the upper arm bone (humerus) with the shoulder blade (scapula).

Rotator Fig.1

These muscles function to provide rotation elevation of the arm and give stability to the shoulder joint.

Incidence of rotator cuff damage increases with age and is most frequently caused by degeneration of the tendon, rather than injury from sporta and trauma.
The supraspinatus is most frequently involved in tears of the rotator cuff.

Diagnosis is made by physical examination, plain radiographs and magnetic resonance imaging.

Rotator Fig.2

MRI permits to determine the extension of the cuff lesion.

Pain, especially at night, weakness and loss of motion are the most common symptoms reported.

In young patients surgery is recommended especially when the dominat arm is affected.
Surgery is performed with the arthroscopic tecnique. A fiberoptic scope and small instruments are inserted through small incisions. The tendons are fixed to bone ancors with sutures inserted in the humeral head. (view movie)

In elderly patients non surgical treatment can provide pain relief and improve the function of the shoulder. If pain relief is not achieved surgical options should be discussed.

After surgery your shoulder is immobilised in a special sling during three weeks to allow the tear to heel. An exercise program will then help to regain shoulder motion ad strength.

Light work is possibile after two to four weeks, complete recovery and retrun to sports activities may take three to six months.