A group of muscles and tendons that surround the shoulder joint, the rotator cuff keeps the ball of your upper arm bone inside your shoulder socket. As such, it plays an important part in helping to raise and rotate the arm. Of course, most of us don’t keep our arms at our sides all day, so rotator cuff injuries are not uncommon. An estimated 200,000 Americans require shoulder surgery to repair a torn rotator cuff every year, and another 400,000 have surgery for related tendonitis or partial tearing (other injuries heal on their own over time or through physical therapy).
Causes of Rotator Cuff Injury
Like many orthopedic injuries, incidences of rotator cuff damage increase with age, and are most common in people over 40; these degenerative tears are more common in the dominant arm, but can affect both. Genetics may also play a role, as researchers have noted that injury appears more commonly within certain families.
The main contributor to rotator cuff injury is repetitive arm motion and overhead work, often attributed to careers such as painting and carpentry. Rotator cuff injuries are also common among athletes, especially tennis and baseball players. Of course, a one-time injury, such as falling on an outstretched arm, can also cause a rotator cuff tear.
Anatomy of a Rotator Cuff Injury
When one or more of the rotator cuff tendons is torn, the tendon can no longer attach fully to the head of the upper arm bone, or humerus. This weakens the shoulder and can make even the most mundane activities, such as getting dressed or grooming, painful, challenging, and time-consuming. Without treatment, the tendons may continue to fray, causing more damage and pain. There is also a lubricating fluid-filled sac called a bursa between the rotator cuff and bone, which aids in motion. When tendons are damaged, the bursa can also become inflamed, adding more pain and discomfort.
Symptoms and Diagnosis of Rotator Cuff Injury
When someone has a sudden tear to the rotator cuff, such as with a fall, they’ll know it; there will be a snapping sensation followed by intense pain and weakness in the arm. For degenerative rotator cuff disease and injury due to overuse, symptoms may include:
Pain at rest and at night, especially when lying on the affected shoulder
Pain when lifting or lowering the arm, or with specific movements.
A “crackling” feeling when adjusting the shoulder
A general weakness, especially when lifting or rotating the arm
To diagnose rotator cuff injury, doctors will test a patient’s range of motion and check for tenderness or deformity in the shoulder; if a firm diagnosis can’t be made, an X-ray will be recommended, followed by an MRI or ultrasound which can provide images of soft tissues.
Treatment and Surgery Options for Rotator Cuff Injury
Nonsurgical or surgical treatment may be recommended depending on the severity of the injury. Nonsurgical treatment may include rest, wearing a sling, avoiding certain activities, taking anti-inflammatory medications, steroid injection, or physical therapy.
Surgical treatment of the rotator cuff will likely be recommended for tears longer than 3 cm, tears caused by acute injury, or if pain lasts more than six months. Partial tears may only require a trimming and smoothing procedure, called debridement, while a complete tear requires stitching the tendon back onto its home on the humerus. There are three types of surgeries:
Open Repair. If tears are large or complicated, an incision several centimeters long is made over the shoulder to detach one of the shoulder muscles, or deltoids. This enables removal of bone spurs and offers access to the torn tendon for repair and reattachment.
Mini-Open Repair. Mini-open rotator cuff surgery uses smaller incisions than open surgery as the deltoid muscle is not detached. A portion of the procedure is also performed arthroscopically.
Arthroscopic Repair. The least invasive of surgeries, arthroscopy involves the insertion of a tiny camera into a small incision in the shoulder joint, which displays images on a monitor. The surgeon then inserts miniature surgical instruments into the incision and, guided by these images, performs the necessary repairs.
Faster Surgical Recovery With BandGrip
Wound closure methods can have a tremendous impact on patient comfort and mobility following a rotator cuff surgical procedure. Sutures and staples aren’t always the best option, as whiskers can be pulled or catch on something, infection may take over, and in some worst-case scenarios, wound dehiscence may occur.
BandGrip Micro-Anchor Skin Closures solves for these challenges, giving patients the comfort and confidence they need to start with their rehabilitation. Completely non-invasive, BandGrip’s patented micro-anchors grip the skin tightly to pull the wound edges together so the natural healing process can take place with minimal scarring.
Find out more about how BandGrip is making life easier for surgeons and patients alike.