Rotator Cuff

Rotator Cuff

  The rotator cuff is actually a set of four important muscles about the shoulder.  These muscle are normally difficult to see, being covered by both the much larger deltoid and trapezius muscles.  However, they are extremely important stabilizers of the shoulder ball-and-saucer joint.  Deconditioning of the rotator cuff muscles can lead to abnormal motions of the shoulder joint and result in pain and weakness.  Therefore, much of the therapy for shoulder injuries is focused on restoring strength and stamina to these important muscles.
  The tendons of the rotator cuff can be injured either by a one-time severe injury or slowly tear by chronic overuse and inflammation.  Once completely torn, these tendons cannot heal without surgical repair.  If no repair is performed, the size of the tear often increases  and the ends of the torn tendons get drawn further and further apart with shortening and scarring of the tendons, as well as irreversible atrophy of the corresponding muscles.  As a result, rotator cuff tears that have not been repaired for many years often become irreparable - the ends of the tendons are just too short and scarred far apart from each other to be brought back to each other to be repaired.  In order to prevent this from occurring, consideration should be given to surgical repair of symptomatic full thickness rotator cuff tears when they are diagnosed.  In the past, repair of rotator cuff tears required an open procedure.  Now, however, techniques have evolved to allow this repair to be done arthroscopically through small incisions and the use of a telescope by surgeons skilled in the techniques of arthroscopic rotator cuff repair.
Example of intact rotator cuff viewed through the arthroscope.  The broad white tendon has no defect.

Example of rotator cuff tear viewed through the arthroscope.  The hole or defect in the tendon substance is the tear.

Same view after arthroscopic rotator cuff repair.  Note that the defect is now closed with suture material.