rotator cuff tears
The rotator cuff is made up of four tendons which all merge to form a sheath or cuff of tissue over the ball part of the shoulder joint. The tendons of the shoulder can tear as a result of injury or degeneration. The tendons usually tear away from the bone. Often this is associated with a bone spur rubbing on the tendon and gradually producing a tear over time. Some tendon tears do not cause symptoms, but for other people this condition can be very painful and restrict their ability to lift the arm above their head.
The treatment can be either non operative or operative. For those not wanting to pursue an operation there is a risk that the shoulder joint itself becomes arthritic as a consequence, and so in most circumstances we would recommend an operation to fix the tendon. However, it is not essential and indeed some people elect not to have an operation on it.
Operations for the tendons of the rotator cuff involves having a look inside the shoulder joint with an arthroscope (like a tiny telescope), and then making a small cut on the shoulder to enable access to the torn tendons. The tendons are then secured back onto the bone using suture material. The tendons then need time to heal back onto the bone. This means six weeks in a sling, followed by a further six weeks doing gentle assisted arm movements. Following this, the arm will not be normal and should be a little painful and stiff. Gradually, strength returns, pain settles and range of movement improves. It is not an operation for the light hearted as it can cause a fair amount of pain.
It is commonly useful to consider how you are going to manage with a sling after the operation. Most people find it hard to sleep after this operation. The use of a reclining chair is often helpful, or propping yourself up on multiple pillows can help.