The rotator cuff is a set of 4 muscles at each shoulder. These muscles work together to keep the “ball in socket” as you move your arm out or overhead. If the tendon of one of these muscles is injured, it will be painful for you lift anything, reach overhead, or reach behind your back. The rotator cuff tendons can be injured traumatically in a fall or other accident or be worn down over time by repetitive activity or use of poor posture. Although the injured tendon is in the shoulder, pain from the rotator cuff is most commonly felt in a band around the upper half of the upper arm. A rotator cuff injury can often be diagnosed based on clinical presentation, but if conservative treatments do not resolve the issue, an MRI may be ordered to determine which of the tendons are involved and whether they are torn or just inflamed.
Rotator cuff symptoms are addressed by conservative treatments initially. These can include use of anti-inflammatory medication, physical or occupational therapy intervention, avoidance of aggravating activities, and possibly use of a steroid injection. If the injured tendon is only inflamed or has a small tear and if you are able to avoid irritating activities temporarily, the tendon can heal without surgery. If a significant tear is involved, surgical repair may be required.
Rotator cuff repair is typically performed arthroscopically on an outpatient basis. During surgery, the surgeon will use sutures to re-attach the injured tendon to the bone. A sling is typically be used for the first 6 weeks after surgery. During that time, a physical or occupational therapist will provide passive range of motion exercises to decrease likelihood of developing frozen shoulder while using the sling. After 6 weeks, therapy will progress to include active range of motion exercises, with light strengthening beginning at the 6-10 week mark. Depending on the type of activity or work you will be returning to, rehab typically lasts for 12-16 weeks.
For information on surgical options, see the link on Dr. Ahn's and Dr. Freehill's page.
