The "rotator cuff" is made up of the combined tendons of some of the smaller muscles around the shoulder joint to allow fine movements of the shoulder, and also to enable the large deltoid muscle to perform the more powerful "gross" movements. The three main muscles that make up the rotator cuff are the supraspinatus, the infraspinatus and the subscapularis. They are attached to the scapula, and run out over the front and top of the shoulder bone (humerus) and attach to it.

Tears to the rotator cuff are common and patients are often unaware they have one as they have no pain and the shoulder continues to function normally. Most tears are due to "wear and tear" on the tendon, but some are due to trauma such as a fall. Tears, either traumatic or due to age, can be painful, and can also limit the motion of the shoulder joint. Most patients complain of pain at the front of the shoulder with an inability to lift the arm up to the front.

Some tears will settle down with physiotherapy, steroid injections and time. Some need to be repaired. Most of the repairs done in my practice are done arthroscopically ("keyhole surgery"), but with bigger or older tears the repair may need to be done "open". The aim of the repair is to fasten the rotator cuff tendons back onto the bone usually using "suture anchors" which are small barbs made of metal, special plastic or absorbable materials with sutures attached. The anchors are inserted into the bone of the humerus and the cuff tendon is tied down onto them.

Recovery can be a long process, particularly if you have a job that is "heavy" in nature with lots of lifting. If you have a predominantly sedentary job your can be back at work very quickly but will be restricted to desk duties only. You will be in a sling for six weeks resting as the shoulder heals. The following six weeks will involve lots of exercises to strengthen the shoulder with a gradual return to full function.

For more information about shoulder arthroscopy click here

For more information about rotator cuff tears click here

For more information on surgery to repair rotator cuff tears click here