What is the rotator cuff ?

The rotator cuff is a group of four muscles that allow you to move your shoulder.  These muscles attached to the shoulder blade and then connect to the arm bone. You cannot see these muscles, as they are deep beneath your deltoid, but provide the strength to let you move your arm normally.

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How do I tear my rotator cuff ?

The rotator cuff can tear when excessive force is applied to the muscles of the shoulder.  The chance for this to happen increases with age, especially over the age of 60.  This happens as tendons in our bodies tend to become more brittle over time, losing their normal ‘stretchiness’ or elasticity.  Tears can occur with lifting heavy objects, injuries to the shoulder, or a result of progressive damage to the tendon with time. A common story I hear in my office is when someone tries to pull a suitcase off the luggage belt at the airport.

The usual symptoms with tears are shoulder pain, pain with activities, pain at night, limited range of motion and weakness.  Not all tears are the same, so it is hard to compare with a friend who said their had a tear in their shoulder.

Tears, unlike pregnancy, are not ‘all or none’.  A tear of a tendon in a shoulder can start small, and get bigger with time and activity.  A small tear may only lead to occasional pain.  As it gets bigger, there may be more a sense of weakness, limited range of motion, and increased pain.

Do I need surgery for my rotator cuff tear ?

There is no simple rule for who needs to have surgery, but understanding the patient and their lifestyle has a guiding hand in making the right decision.  In some cases, it is best to learn to live with it, and work around the pain.  For many, this is not a reasonable option and repairing the tendon is the best choice to restore strength and eliminate pain.  Repair can be done either through small stab incisions using arthroscopic techniques or with a very small incision.  The only way to know for sure is to see your orthopedic surgeon and get a good opinion on what the next step should me.
If you have questions about rotator cuff tears, or have a rotator cuff tear, please feel free to contact me at Ask Dr. Hacker or through my office.

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