Rotator Cuff Injuries

Rotator cuff injuries are well-publicized injuries when they occur in professional athletes but in reality, they are much more common in patients over the age of 60 than in patients under the age of 30. Rotator cuff injuries are becoming more and more common as people remain active as they age. Over half of patients over 60 years of age have been shown to demonstrate rotator cuff tears. Increasing attention is being paid to advances in rotator cuff injury prevention and treatment techniques as the percentage of our aging population grows.
 
The shoulder is a ball-and-socket joint made of the humeral head, the ball, and the glenoid, the socket. This joint can be thought of as a golf ball, humeral head, on a golf tee, glenoid. The shoulder is stabilized by a labrum, which is a rubbery piece of cartilage that sits around the glenoid like a gasket, thus deepening the “socket.” It is also stabilized by a capsule of ligaments around the socket and by the rotator cuff.

The rotator cuff is a “cuff” of four tendons that envelops the ball. It is made of the tendons from four different muscles. These muscles work together to position the ball in the socket so that the shoulder’s larger muscles, such as the deltoid, can move the shoulder in space and perform lifting, rotating, and pressing activities.

Rotator cuff injuries can occur with a traumatic event such as a fall onto the shoulder or a dislocation. They can also occur as a result of wear and tear. Many people develop rotator cuff injuries over time due to a gradual process of irritation and inflammation of the rotator cuff eventually leading to partial or full thickness tears.

Common complaints of patients with rotator cuff tears include pain with overhead activities, loss of strength with certain activities involving the shoulder, and difficulty sleeping on the affected side.

Many small or partial rotator cuff tears can be treated successfully with physical therapy. In the tears that do not respond to therapy, clinical studies of rotator cuff repairs have shown good results according to shoulder function and patient satisfaction scores.

Robert Klitzman, MD is an orthopedic surgeon at McBride Clinic and is board eligible by the American Board of Orthopaedic Surgery. He received his medical degree from the University of Oklahoma Health Sciences Center. He completed a residency in Orthopedic Surgery at Northwestern University, Feinberg School of Medicine in Chicago, Illinois and a fellowship in Sports Medicine at Baylor College of Medicine, Department of Orthopedic Surgery in Houston, Texas.