The rotator cuff is a group of muscles and tendons that form a “cuff” over the shoulder joint.
The four muscles of the rotator cuff – supraspinatus, infraspinatus, subscapularis, and teres minor – can be thought of as a “T” that originates from the scapula or shoulder blade, which is like a wing bone. Together, they, along with other tissues, form a single tendon unit that forms a cuff around the humerus (the upper arm bone).
The rotator cuff helps to lift and rotate the arm and to stabilize the ball of the shoulder within the joint. Sometimes, however, the rotator cuff will tear.
In this blog, orthopedic surgeon Dr. Francis X. Mendoza will explain when rotator cuff surgery is recommended.
What causes a rotator cuff tear?
Tendons have areas that receive a very low supply of blood, so they’re not able to quickly repair themselves. As a result, a tear can often occur from degeneration that’s related to chronic wear and tear and excessive friction.
The injury is particularly common after age 40, but a rotator cuff tear can occur at any age. This is especially true if you repeat the same type of overhead shoulder motion often – as is the case with baseball pitchers, many of whom need rotator cuff surgery at some point in their careers. A fall can also cause this type of injury.
If you’ve torn your rotator cuff, you’ll typically feel pain in the front of your shoulder that radiates down the side of your arm when you’re lifting or reaching overhead. You may also feel a catching sensation when you move your arm. In some cases, the tear is partial, and you’ll still be able to move your arm in a normal range of motion.
You may feel pain when you sleep on the injured shoulder, and you may also experience weakness of your arm and have trouble with everyday tasks such as combing your hair.
If the tear occurs as a result of an injury, you may experience sudden, acute pain and a snapping sensation. Your arm may be immediately weakened.
When should you see a doctor for a rotator cuff tear?
If you’ve injured your shoulder or have ongoing shoulder and arm pain, an evaluated by an orthopedic surgeon is recommended. He or she may recommend a diagnostic study such as an MRI (magnetic resonance imaging) to confirm a diagnosis of a torn rotator cuff. The earlier you can get an accurate diagnosis and begin treatment, the better, because this may keep symptoms such as loss of strength and loss of motion from setting in.
If your primary physician has already diagnosed you with a torn rotator cuff, an orthopedic surgeon can review your surgical and nonsurgical options and start treatment. Nonsurgical options may include physical therapy, rest, and/or medication.
When is rotator cuff surgery recommended?
Rotator cuff surgery is recommended if you have persistent pain or weakness that isn’t sufficiently improved with nonsurgical treatment. Most tears won’t heal on their own, but nonsurgical treatment may help alleviate their symptoms in some cases.
Patients who need surgery often experience pain at night and have difficulty using the injured arm for lifting and reaching. Many still experience ongoing symptoms that aren’t sufficiently relieved despite several months of medication use and limited use of their injured arm.
Surgery is also recommended for active patients who use their arm for overhead work or sports.
Where can I find the best rotator cuff surgeon in Manhattan?
Francis Mendoza, M.D., is a graduate of Columbia University College of Physicians & Surgeons. Since completion of his orthopedic and shoulder training at Columbia Presbyterian Medical Center, he has served as the Director of Shoulder and Elbow Surgery at Lenox Hill Hospital.
Dr. Mendoza is a member of the American Shoulder and Elbow Surgeons, the Mid-Atlantic Shoulder and Elbow Society, and the American Academy of Orthopaedic Surgeons.
If you’re experiencing shoulder pain or weakness or have already been diagnosed with a rotator cuff tear, schedule an appointment with Dr. Mendoza today!