Rotator cuff forms the most important muscle group for function of the shoulder joint. It remains responsible for all rotations and initiation of the abduction of shoulder joint.
There are mainly four muscles in the group:
- Supraspinatus: responsible for lifting up the arm
- Infraspinatus & Teres minor : External rotation of the arm
- Subscapularis: Internally rotates the arm
These functions are not overlapped by any other muscle group. In cases with rotator cuff pathology, the tendons of these muscles undergo degenerative changes or may be secondary to trauma, they develop microtears. This leads to painful disability to perform these functions. The ailment may present with a wide array of symptoms.
- Typical night pains
- Stiffness of shoulder in morning
- Pain radiating to upper arm
- Tingling and numbness in arm
- Neck spasm and pain
- Difficulty in lifting the arm
- Inability to hold the arm in a position
- Pseudo-paralysis of shoulder
- Painful restricted range of motion
- Upper back pain and peri-scapular pain- typically involving medial border scapula.
These symptoms are variable and patients present with their own set of these. The patient needs thorough clinical evaluation for muscle strength and rotator cuff function. This when supplemented with radiological investigations guides the surgeon for the modality of treatment offered. The cases with isolated tendon involvement do better than patients with larger cuff tears. In chronic cases the results of repair remain guarded.
The surgery essentially form the last resort in cases of tendinosis/tendinopathy who fail to improve with conservative treatment or cases with a symptomatic diagnosed rotator cuff tear. Case selection for surgery remains imperative for excellent functional outcomes.
The surgery includes use of suture anchors which are drilled in the bone. The sutures through these anchors is indivisually passed through the torn rotator cuff muscles and approximated with the anchor using a knot. This is all done using minimally invasive techniques which results in better functional results.
For more information please feel free to consult our Orthopedic team or contact us for any query.
Rotator cuff strengthening exercises are essential for rehabilitation of tendinopathy and post operative patients.
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