What is a rotator cuff?

The rotator cuff is a series of muscles and tendons that attach to the ball (humerus) of the shoulder and function to stabilize the joint and allow the arm to be positioned away from the body.  There are four muscles of the rotator cuff: subscapularis, supraspinatus, infraspinatus, and teres minor. These muscles do the work of the rotator cuff, allowing the shoulder joint to move with a great degree of flexibility while keeping it stable. Partly because of the dual role of the rotator cuff, it is a common source of injury and pain in the shoulder.

How does the rotator cuff become injured?

The anatomy of the shoulder allows it great flexibility in motion but also makes it susceptible to injury. The rotator cuff is at risk for injury during both repetitive motions during work or sports, such as reaching above one’s head, and traumatic events, such as falls and car accidents.  Sometimes the inciting cause of the injury is unknown, and just happens as a result of “wear and tear”.  Injury or damage to the rotator cuff is frequently the reason for shoulder and arm pain with activity and at night. In some cases, severe injury can lead to weakness in the arm and difficulty with motion at the shoulder.

How are rotator cuff injuries treated?

A mild rotator cuff injury can be treated with activity modification, anti-inflammatory medication, injections, and physical therapy to reduce inflammation and improve range of motion. Specific forms of exercise keep the joint flexible and improve the condition of the supporting muscles and tendons. If the tear is full thickness or non-surgical treatments fail to improve symptoms, surgery may be an option. Our physicians perform all tendon repairs of the shoulder arthroscopically, using noninvasive keyhole surgery to reattach or repair the damaged rotator cuff tendons using state of the art techniques.  Arthroscopy lessens postoperative pain and minimizes recovery time in comparison with traditional surgery. 

I have a rotator cuff tear.  How do I know if I will require arthroscopic surgery?

Not all tears require surgery and treatment is individualized.  The decision for surgery depends in part on the severity of damage, which is determined oftentimes in conjunction with an MRI.  Our physicians will examine your arm and discuss the results of your MRI with you so can understand and see the tear.  Tears can get worse and there are sometimes downsides to not having them repaired.  Our physicians will help you make the treatment decision most appropriate for your individual case. 

If I decide to have my tear repaired, what can I expect?

Rotator cuff surgery is done arthroscopically through tiny keyhole incisions and is done as outpatient surgery where you leave the surgical facility the same day.  A sling is worn typically for several weeks during which time the tendon heals.  Most patients resume all of their activities when the sling is discontinued.  The majority of the symptom improvement is achieved by 2-3 months following surgery.  Our physicians will review expectations specific to your individual case.