Rotator Cuff

The rotator cuff is made up of four tendons which attach to the muscle to provide stability of the ball within the socket of the shoulder. These muscles that form the tendons are Teres minor, supraspinatus, infraspinatus and subscapularis. They help with the inward and outward movement of the shoulder.

The cuff sits between the humeral head and acromion as the arm slides upwards.

Rotator cuff tear is the most common cause of pain in middle aged adults. It is often caused by excess pressure on the cuff from the shoulder as the arm is lifted due to excessive overhead activities, sporting injuries or vehicle accidents. There is also evidence to suggest that smoking, hypercholesterolemia, and family history can also be predisposing factors to tears.

Symptoms of a Rotator Cuff tear

Treatment

Conservative

Not all cuff tears need to be treated surgically, some small full-thickness tears can be managed by non-surgical treatment as the first line and may be effective. Some of these include:

Surgical

A rotator cuff repair is a procedure performed to reattach the torn tendon back to the bone. This surgery is commonly performed arthroscopically but can be open depending on the size and extent of the tear.

The surgeon will often perform an arthroscopy first and excise any inflamed tissue. A subacromial decompression is performed to provide more space for the tendon. Anchors are placed in the bone and the sutures contained in the anchors are attached to the tendon to bring back to bone.

Risks of the surgery

References

Miniato, M.A, et al, (2021) Anatomy, Shoulder and Upper Limb, Shoulder. StatPearls Publishing LLC. Treasure Island

Shoulderdoc (2022) Bones & Joints of the Shoulder. Accessed 18 September 2022 https://www.shoulderdoc.co.uk/article/1177

Sonnabend D. H. and Young, A.A. (2009) Comparative anatomy of the rotator cuff. The Journal of Bone and Joint Surgery. British volume. Vol. 91-B, No. 12