Everything you Need to Know about a Torn Rotator Cuff

The rotator cuff is a group of muscles and tendons in each shoulder that holds your upper arm bone in its socket. It keeps your arm stable while allowing it to lift and rotate. Too much stress on the rotator cuff can cause a tear. This can be a painful injury.

A rotator cuff tear can happen:
– Because of a fall with an outstretched arm.
– It can happen if you try to lift something heavy with a jerking motion.
– It can also happen over time, as part of the regular wear and tear associated with aging – especially if you have done a lot of repetitive motions with your arms.

If you have a torn rotator cuff, you may:
– Feel pain in your shoulder.
– It may hurt when you are resting.
– It may hurt MORE when you lift or lower your arm.
– Your arm may feel weak when you try to move it.
– You may feel a crackling sensation when you try to move your shoulder in certain ways.

Your torn rotator cuff can be treated:
– With immobilization – a sling, that lets your shoulder rest enough to heal
– With Oral or injectable anti-inflammatory medications (ibuprofen, cortisone, etc.)
– You may benefit from physical therapy
– If none of these treatments work, you may need surgery.

Acromioplasty
For a minor rotator cuff tear, acromioplasty can help repair a torn rotator cuff. Acromioplasty may involve shoulder debridement and acromioplasty. During acromioplasty, Dr. Paley can cut and reshape the end of the acromion to alleviate pressure from the rotator cuff tendons and create adequate spacing.

Shoulder Debridement
Minor rotator cuff tears may successfully be treated with shoulder debridement, which uses an arthroscope to remove any damaged, unhealthy, or worn portions of the tendon. Arthroscopic rotator cuff surgery is typically less invasive because it requires a smaller incision than open rotator cuff tear surgery. Following shoulder debridement, the remaining healthy tissue of the tendon will begin to heal itself again.

Arthroscopic Rotator Cuff Repair
An arthroscope is a small tube with a camera at the end that can be used during rotator cuff surgery. The arthroscope is gently inserted through a small incision in the shoulder. The images from an arthroscope are shown on a monitor during surgery. This gives Dr. Paley a live view of your shoulder without needing a larger incision to view the structures of the shoulder. During arthroscopic rotator cuff repair, Dr. Paley will remove any damaged or unhealthy tissues from the rotator cuff. The top of the upper arm bone is then prepared for the tendon to be reattached. He will remove the outer layers to create a bony area. Small holes are made within the upper arm bone where sutures can be placed. The tendon is then repaired and stitched to the upper arm bone with sutures that circle through the holes. These devices are known as suture anchors for rotator cuff surgery. With time, the damaged tendon will heal and attach to the upper arm bone.

Open Rotator Cuff Tear Surgery
In more severe cases of a torn rotator cuff, open rotator cuff tear surgery may be required. Open rotator cuff tear surgery cannot be performed through an arthroscope and requires a larger incision to be made so that Dr. Paley can see the internal structures of the shoulder. Once an incision is made, he will begin to gently separate the tissues and structures of the shoulder until the rotator cuff is viewable. Once the rotator cuff has been repaired, the muscles will then be placed back in their natural position, and sutures will be applied to the incision.

Rotator Cuff Grafts
If a rotator cuff tear cannot be repaired through other torn rotator cuff surgeries, rotator cuff grafts may be required. Rotator cuff grafts may be needed in patients who have had a rotator cuff tear for a long period of time. If a patient has had a damaged rotator cuff and has not undergone rotator cuff tear surgery, the surrounding muscles may constrict and can no longer be reattached properly. In cases like this, rotator cuff grafts or tendon grafts may be needed to bridge the distance between the torn rotator cuff and upper arm bone.