The rotator cuff in the shoulder consists of 4 different muscles (Supraspinatus, Infraspinatus, Teres Minor and Subscapularis). These muscles are crucial to keep the shoulder joint stable during movement. The most common rotator cuff muscle to be torn is the supraspinatus muscle where the tendon attaches to the bone. This muscle is located on top of the shoulder joint and under the acromion process of the shoulder blade (see pictures below). One of the reasons this muscle is the most common to be torn is from repetitive overhead motion. A person can also sustain a rotator cuff tear as a result of a trauma to the shoulder such as falling on the arm or lifting something very heavy. Diagnosis is usually made with a Magnetic Resonance Imaging scan (MRI).
Symptoms of a rotator cuff tear include pain with use and during sleep, weakness especially with overhead activities and a “grinding” in the shoulder joint with motion.
If the tear is a full thickness tear, surgery is most likely needed as the tear will not heal on its own. This population of people are usually active, or with longstanding symptoms, large tears, significant weakness or acute injury. The usual circumstances that surgery is not performed are if the full thickness tear is small or the person is not able to tolerate a surgical procedure for medical or age related reasons.
Rehabilitation after surgery occurs in stages. Usually there is a period of rest and immobilization (4-8 weeks), then as the tendon repair gets stronger (8-12 weeks), flexibility exercises are performed gradually introducing strengthening. Full recovery can take up to 12 months. Each surgeon has their own specific protocol they prefer to use. It is extremely important that there is good communication between the surgeon, therapist and patient for a successful result.