Rotator Cuff

What is rotator cuff?

Rotator cuff is the structure consisted of four muscles, which surrounds the shoulder joint located on top of the humerus (upper arm bone). It holds the shoulder joint intact, and allows moving the shoulder.

How does a rotator cuff tear occur and how does one notice it?

Rotator cuff tears can occur due to acute injuries like falling or due to chronic causes based on degeneration. It is generally thought to be occurring due to a tendinosis below the acromion in front of the scapula, especially after the age of 40. The symptoms include pain from the shoulder to arms in the first place. There may also be pain in overhead movements of the arm. The pain may increase during lying down on the affected side. The arm loses its strength and there may be difficulties in performing certain activities like combing the hair or scratching the back.

How is a rotator cuff tear diagnosed?

Your doctor conducts an examination with a detailed medical history and some special tests regarding rotator cuff tear. Shoulder x-rays and medical ultrasound are utilized along with MR imaging in order to make a certain diagnosis and understand the structure of the tear as well as to reveal any possible accompanying diseases.

How is a rotator cuff tear treated?

If you have a rotator cuff tear in your shoulder and you continue to use your arm despite an aggravating pain, you may cause the tear to get larger. The existence of a chronic pain in the shoulder or the arms is a sufficient reason to consult a doctor. Early treatment is the best method in preventing the exacerbation of symptoms. It may provide an earlier return to normal life as well.

The purpose of treatment is to remove the pain and provide a recovery of the functionality. Your doctor will offer you the most suitable treatment method according to your age, level of activity, general condition, and the current state of the tear.

Non-surgical treatment methods

It is possible to relieve the pain and recover the functionality in 50% of the patients without surgical treatment.

• Rest: Your doctor may suggest you to rest and avoid overhead movements of your arm. You may also be given an arm sling in order to stabilize and protect your shoulder.
• Avoidance of activity: Activities that cause shoulder pain should be avoided.
• Medical treatment: The pain can be relieved through medication.
• Physical exercise: The range of motion could be regained by a special exercise program and the rotator cuff muscles could be strengthened.
• Steroid injection: Steroid injections by local anesthesia can be useful in removing the pain and recovering the functionality in cases where rest, medication and physical exercise fail. 

Surgical treatment

You may be suggested a surgical treatment if the pains are not relieved or the functionality is not restored through non-surgical methods.

Situations where surgical treatment is considered

• Symptoms are not relieved within 6-12 months 
• Loss of strength and functionality in the shoulder
• The tear is larger than 3 cm
• The tear is occurred recently