Rotator Cuff Tears

The rotator cuff is composed of 4 muscles: the supraspinatous, infraspinatous, subscapularis, and teres minor. The supraspinatous is the primary muscle in this group that assists in raising your arm up and over your head. Without the supraspinatous, you would have chronic weakness with lifting your arm over your shoulders. Some patients have tears in their RTC that have been there for years but they are still able to reach above their head as their body has compensated for the mobility usually using the deltoid. These patients may be able to reach above their shoulders and head but will have very little strength.

Not all rotator cuff tears need to be fixed immediately. Some patients have tendinitis or small/partial tears. If this is the case, they may be able to put off surgery depending on their symptoms. If pain and/or weakness continues in these cases, surgery is usually recommended.

For large rotator cuff tears that are acute (less than 3 months old), we prefer to fix them sooner rather than later. If a tendon is not attached to its bony landmark, then it will not function. And if you don’t use it, you’ll lose it! Meaning, a tendon that is not functioning will become fatty tissue. Fatty tissue is irreparable. This process takes several months to years to occur. The decision for surgery, again, does not always have to be right away but we usually recommend having surgery within a 4-6 month period of symptom onset. Surgery usually entails a same-day arthroscopic (scope) procedure. Therapy is strongly recommended postoperatively. Recovery can take up to 3-4 months to return to normal daily activities but rehabilitation differs depending on the patient and the severity of the tear. Usually, the larger the tear, the longer the recovery. But, every patient is different. Some recover faster than others. We hope this information can help our patients better understand the condition and treatment options for rotator cuff tears.

ANATOMY

ROTATOR CUFF REPAIR