The rotator cuff is the name for a group of four muscles that help to keep the top of the arm in place in the socket of the shoulder joint. Without them the shoulder would simply dislocate every time that you tried lifting anything. All these muscles are connected to the scapula or shoulder blade at one end and the upper arm or humerus at the other and surround the shoulder forming a cuff of muscle around the shoulder joint, hence the name.
A rotator cuff tear is a tear in one or more of these muscles either through too much pressure being put on them or through wear and tear caused by overuse or just old age. One comparison I have heard is that of comparing the tendons of the cuff to an old car tow rope. If you try pulling something that is too heavy the rope will tear or snap and if you have been using the same old tow rope for many years it can become frayed through overuse.
Cuff Tears often come about through a sudden trauma. If, for example, you were to fall and put your arm out to catch yourself the sudden impact can tear the muscle. Lifting something heavy could have the same effect but would cause a different type of damage as the load is likely to be added more slowly. The tendons and muscles can also just wear out through repeated use either through age or because a work or leisure activity over uses the muscle. Anyone who throws a baseball repeatedly is putting strain on their rotator cuff. Any repetitive overhead action like painting can have teh same effect.
A tear in the rotator cuff has specific symptom such as weakness in the arm, pain when doing certain movements, especially reaching up or behind you. The test for a rotator cuff tear will usually involve getting someone to gently push against the doctor's hand whilst mimicking these movements; this will usually result in pain confirming the diagnosis.
Treatment can vary depending on the age of the person and the size of the tear. Small or short tears are easiset to fix and will probably only need anti-inflammatory drugs and physiotherapy, whilst larger tears may involve keyhole surgery to mend the tear or free up space for the inflamed muscle to move more easily eliminating pain altogether or limiting it.
The younger you are when you have surgery the greater the success rate. As you get older the success rate of the procedure can drop to around 60%. It is sometimes worth considering what you see as a successful outcome. Obviously, if you are a serious sportsperson the ideal outcome would be a return to full fitness. On the other hand, if you lead a fairly sedentary lifestyle the aim may be to be able to carry out certain everyday tasks and movements pain free.
Rotator cuff tears come in a variety of shapes and sizes and so they can vary quite considerably in treatment and prognosis. Physiotherapy will always be a part of any treatment but it needs to be rotator cuff specific exercises aimed at exercising and strengthening the group of muscles without causing any further damage.
Having torn my rotator cuff and ending up with a shoulder impingement I started to research shoulders and the rotator cuff to better understand my own injury. Check out my blog for more useful information
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