Shoulder Rotator Cuff Surgery: The Injuries That Lead to Injury and Surgery

Rotator cuff injuries are some of the common causes of shoulder surgery. A study showed the rates of shoulder rotator cuff surgery and repairs went up by 141% between 1996 to 2006! The rotator cuff is the reason why we can lift the arms above our head, or be able to swim and play sports like baseball and tennis.

What Is a Rotator Cuff?

The rotator cuff actually refers to a group of four muscles in the shoulder working together to support the ball and socket shoulder joint in performing such tasks. The four muscles include:

  • Supraspinatus hold the long arm bone called humerus in its place and allows you to lift your arm.
  • Infraspinatus is the main muscle involved in rotational and extension movements of the shoulder.
  • Teres Minor is the smallest of the four muscles and assists in abduction movement or helps move the arm away from the body.
  • Subscapularis muscle helps in stabilizing the upper arm bone and in rotation, straightening and lowering of the arm.  

Besides the muscles, the rotator cuff is also supported by tendons and bursa, which is a fluid filled sac that cushions the rotator cuff.

Reasons For Rotator Cuff Injuries

There are many reasons why the rotator cuff can get injured, resulting in shoulder rotator cuff surgery. According to sports medicine doctors, lifting heavy weights, overuse from repetitive actions, such as swimming or throwing a baseball, and even the wearing out of tendons as normal part of aging can all lead to tear or inflammation in muscles and tendons in the rotator cuff. The symptoms can include pain, stiffness and weakness in the shoulder and loss of movement.

When the rotator cuff is damaged, either due to wear and tear or weakness, it fails to keep the humerus aligned to the shoulder socket. The abnormal alignment leads to impingement of the rotator cuff tendons and muscles.

  • Tendinitis refers to mild inflammation of the rotator cuff tendon which is usually treated with rest and physical therapy.
  • Tendinosis refers to degenerative rotator cuff tissue and can be addressed with physical therapy but chronic cases may require surgery.
  • Incomplete tears in the rotator cuff can occur as a result of severe trauma or repetitive stress to the shoulder joint and can progress to complete tear if not addressed. Full thickness or complete tears occur when the rotator cuff tendon is completely detached from the bone. Medium and large tears that involve tears in more than one tendon require surgery to immediately correct and improve range of motion.

Shoulder rotator cuff surgery is also the best option in the following instances:

  • Chronic symptoms of moderate rotator cuff injury that do not respond to the usual physiotherapy and rehabilitation exercises
  • Athletes or active people who sustain acute injury and need to get back to competitive sports
  • Laborers or workers who have to lift their arms during work
  • Extensive damage to rotator cuff muscles detected on MRI or X-ray
  • Extensive degenerative disease such as osteoporosis or osteoarthritis

Arthroscopic shoulder rotator cuff surgery is conducted to repair the plethora of symptoms and injuries. The surgery involves removing the fragments of tendons and bursa and creating more space so that the tendons are not pinched and stitching the torn tendon up.

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