What is the function of the rotator cuff?
The rotator cuff consists of four muscles that originate from the shoulder blade and insert on the upper humerus bone, enveloping the shoulder joint. The function of the rotator cuff is to stabilize the ball-and-socket joint so that the larger muscles (pectoralis major, latissimus dorsi, etc.) can enact forceful movement of the arm for strength and agility. The four rotator cuff muscles are named: supraspinatus, infraspinatus, teres minor, and subscapularis. Rotator cuff tendon tears most frequently involve the supraspinatus and, to varying extents, the infraspinatus. More extensive tears may also involve the subscapularis, however the teres minor is typically spared.
I was diagnosed with a torn rotator cuff. Do I need surgery?
If you have a torn rotator cuff tendon, there are some important factors to consider in choosing the treatment option that is right for you. Many people are able to function normally by strengthening the remaining/intact rotator cuff tendons (typically the subscapularis) through physical therapy and modifying their daily activities to avoid forceful overhead use of the affected arm. This is a reasonable option if you are not an avid athlete and do not feel limited in your day-to-day function. If you choose this non-operative approach, it is recommended to have repeat MRI scans every 6 months – 1 year to ensure that the tear is not progressing in size or extent.
What is the treatment for a torn rotator cuff?
Small or partial thickness tears in younger patients (< 40 years old) are amenable to treatment with biologic agents (platelet-rich-plasma (PRP)) to enhance healing. Medium/large tears and those with full thickness involvement and tendon retraction are best addressed with surgical repair through shoulder arthroscopy.
There are certain important elements to consider when deciding which treatment option is best for you and Dr. Garabekyan will be happy to have this discussion with you.