Rotator cuff tear

We are here to help you and discuss options

A rotator cuff tear may affect your normal everyday activities such as brushing your hair, carrying bags or putting on your coat. The consultant orthopaedic surgeons at Schoen Clinic are specialists in treating shoulder disorders and injuries. It is not always possible to restore full function after this injury, however there are numerous options available to you.

What is a rotator cuff tear?

Your shoulder consists of three bones; the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). The shoulder joint is a ball and socket joint within the joint there is a group of four tendons which help to stabilise the shoulder and elevate the arm, together these tendons make up the rotator cuff.

The rotator cuff attaches your upper arm to the shoulder blade and is essential for lifting and rotating your arm. The tendon of the rotator cuff passes through a narrow space between the bone on top of the shoulder (acromion). The tendon can be pinched in this sub-acromial space and over time can lead to wear and ultimately a tear. The chance of this increases as we get older.

Rotator cuff tear: Symptoms

Patients with a rotator cuff tear may report a dragging or stabbing pain in the shoulder region that can radiate up to the neck area or down to the hand. This pain is typically more severe at night, restricting the ability to have a good night sleep. Moving the arm forwards or to the side may be painful.

Causes: How does a rotator cuff tear occur?

There are many causes behind a rupture of the rotator cuff, however this is usually an attrition tear after years of wear. While around just 5% of tendon tears in the shoulder joint occur as a result of an accident in younger patients, rotator cuff ruptures due to degeneration are much more common, making up approximately 95% of cases. In this instance, the tendons have already been damaged due to wear. A minor fall or simply over-reaching may be sufficient to damage the tendons.

Diagnosis: how we determine a rotator cuff rupture

X-ray imaging for the shoulder

X-rays can be useful at imaging the bones of the shoulder. Alternatives which can show the bones and soft tissues include ultrasound and magnetic resonance imaging (MRI).

Ultrasound and MRI

Using ultrasound examination (sonography) and MRI we can visualise the soft tissues of your shoulder. Ultrasound examination allows a dynamic check. MRI examination offers the most accurate view of the area.

Treatment options

Your surgeon will discuss all options available; from physiotherapy to surgery. The right treatment for you will depend on many factors including your age and functional requirements. Surgery may help you achieve more but in many cases is not absolutely necessary.

Minimally invasive methods (arthroscopy)

Our specialists will describe the various surgical options to you including the use of minimally invasive methods (arthroscopy). This allows our surgeons to take a look into the joint and repair the tendon where possible. The size of the tear, the quality of the tendon and your age are factors which will help to determine whether it can be repaired. The repair can usually be carried out at this time.

There are situations where your surgeon may be able to repair a bigger tear by using an open technique. Sometimes an artificial tendon replacement can be used and occasionally a muscle-tendon transfer can be used as a mechanical replacement. As a final option there is a role for a reverse geometry shoulder replacement. Your surgeon will discuss all of these options with you prior to any procedure.

Physiotherapy

It may be possible to avoid surgery and physiotherapy/rehabilitation can achieve a good result with mobility returning to the shoulder.


Rotator cuff tear: Our specialists

With experts in all aspects of shoulder conditions, your rotator cuff injury is in the best hands possible at Schoen Clinic. Our specialists work as part of a multidisciplinary team, ensuring you get the appropriate treatment for your individual condition.

Rotator cuff tear: Our specialised hospital

Schoen Clinic Orthopaedic and Spinal Hospital in London boasts some of the finest specialists, diagnostic equipment and clinical outcomes there is to offer. Your treatment journey is thoroughly planned from beginning to end putting you in the centre of your care.