Side view of muscles forming rotator cuff tendon
(Left) Normal intact tendon, (Right) Torn cuff tendon with exposed humerus head
Treatment of Rotator Cuff Tear Injury (Shoulder)
 The rotator cuff is composed of four muscle-tendon units that cover the shoulder joint and function to achieve overhead arm movement and helps to stabilize shoulder joint. If not treated, rotator cuff condition may lead to permanent loss of motion and weakness and may result in progressive degeneration of shoulder joint (Cuff Tear Arthritis). Most of the patients of rotator cuff conditions can be treated without surgery. The success of non-surgical treatment depends on the type of tear (Partial or Complete), if patient had a traumatic event or if patient has symptoms or no symptoms.
The goal with non-surgical treatment is to reduce inflammation and pain. Non-surgical treatment includes rest, ice, medication, physical therapy and cortisone injections to relieve pain and promote patients compliance for exercises. If there is rotator cuff injury or risk at developing injury as in overhead jobs or sports activity regular shoulder strengthening exercises will prevent further damage to the cuff tendon. Some of the fitness freaks who do repeated forward or side elevation arm with weights are advised to do shoulder capsule stretches and cuff strengthening exercises as well to avoid tightening of posterior shoulder joint capsule (Internal rotation deficit) which may further damage important shoulder supporting tissue. Physical therapy is first line of treatment for rotator cuff injury. It is focused to improve joint mobility and to strengthen muscles which are not injured to compensate for the torn muscle-tendon unit and restore the function. Patient is advised to undergo supervised physiotherapy for initial few weeks.
Dr. Abhijit Ranaware will plan the arthroscopic repair of torn cuff tendon depending age of patient, activity level, size and retraction of torn tendon. Surgery is done with small key-hole incision by a telescope (Arthroscope) with attached camera which will show damaged cuff and other pathology of shoulder joint. Once the torn tendon is identified and mobilized it is repaired to bone by special implants like suture anchors placed in single or double row (anatomic foot print repair). Dr. Abhijit Ranaware, Shoulder and Arthroscopy Surgeon in Pune is highly experienced to treat rotator cuff tear with minimally invasive surgery technique and helps patients in returning to a healthy and active lifestyle.
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Post-operative rehab
After surgery patient is suggested to apply ice and brace is given for initial few weeks to prevent shoulder movement. Patient is discharged from hospital on the immediate next day and advised to undergo supervised Physiotherapy sessions. Post-op Physiotherapy is aimed to restore movement and strength of muscles which is very important to achieve best results.
