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What is the rotator cuff?

A rotator cuff is a group of four muscles named supraspinatus, infraspinatus, subscapularis, and teres minor. These muscles form a “cuff” over the head of the humerus and attach to the shoulder blade. These muscles help lift and rotate the arm and stabilize the ball of the humerus (top of your long arm bone) in the shoulder joint itself.

What Causes Rotator Cuff Tears?

There are many different ways a person can develop a rotator cuff tear. The two most common are an acute injury (such as a fall or a sports-related injury) or natural age-related wear and tear of the tendons. The specific muscle injured, the extent of the damage (a full tear versus a partial tear) and how your body perceives and responds to the injury will determine how you are affected.

When Should I See My Doctor?

If you have injured your shoulder, or are experiencing chronic arm pain, a consult with your doctor may be beneficial. A large number of rotator cuff tears are non-surgical. Your physician may recommend undergoing conservative treatment, including therapy. If pain persists, typically an orthopedic referral is completed, as well as imaging, in the form of an MRI.

Types of Rotator Cuff Repairs

The most common types of rotator cuff repairs seen at the VGH clinic include:

  • Arthroscopic Rotator Cuff Repair: This is the least invasive type of repair and involves small incisions for the surgeon to insert both surgical instruments and a camera to complete the procedure.
  • Mini-Open Rotator Cuff Repair: This procedure uses both open surgery and arthroscopic techniques. Arthroscopy is used to assess for bone spurs and loose cartilage that may be irritating the tendons. From there a larger incision is to give direct visual access of the tear to the surgeon is made.
  • Open Rotator Cuff Surgery: This type of surgery is the most invasive. Patients who have more substantial, more complicated tears that may be difficult to access with a scope or patients in need of tendon transfers or reconstruction undergo this surgery.
If I Have Surgery, How Long Do I Have to Do Therapy?

The length of therapy is entirely subjective and dependent upon multiple factors. Factors include the extent of the initial injury and the type of repair completed. The body’s response to pain and the ability to heal are considered. If your health includes certain chronic conditions, it may impact recovery. Complications like frozen shoulder and infection, among others, can also affect recovery. Your compliance with your therapist recommendations, including pain management techniques, exercises, and stretches is also a factor. Typically, the average patient who undergoes shoulder surgery can expect at least 12 weeks of therapy. That allows time for the muscles to heal, tolerate functional movement, and will enable a person to return to prior routine with minimal discomfort.

For more information on rotator cuff tears, speak to your primary care physician at your next appointment, or discuss with your occupational therapist at Virginia Gay Hospital. For information on primary care providers please visit our Find a Provider page. To learn more about therapy services at Virigina Gay Hospital, please visit our Therapy Services page.

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