Rotator Cuff tears

Rotator cuff tears can occur as a consequence of either direct trauma or secondary to overuse. Often in the case of overuse, the tendon involved may already exhibit characteristics of a tendinopathy/tendinosis. To complicate matters further, this already weakened tendon may not necessarily be symptomatic prior to the development of a tear.

Rotator cuff tears can be characterized as either partial or complete.  Partial tears can vary both in depth and extension of the tendon. They may involve either the underlying surface of the tendon close to the articular surface (>80%) of the humeral head or the bursal surfaces (<20%) i.e. the upper surface of the tendon close to the subacromial bursa. Full thickness tears of the rotator cuff tendons extend through the entire thickness of the tendon allowing direct communication between the subacromial bursa and the glenohumeral joint.

Rotator cuff tears can occur in any of the rotator cuff muscles but are generally most common in the Supraspinatus and then Infraspinatus and Subscapularis respectively. Furthermore, these tears are often found in the dominant arm.

Treatment of Rotator Cuff Tears

Treatment of rotator cuff tears will initially involve a course of conservative treatment. At our City of London Chiropractic clinic, our approach is based on initially reducing the pain and from here the long term goal is focused on improving the mobility of the shoulder and strengthening up the remaining Rotator cuff musculature to improve shoulder function. Postural exercises, eccentric loading exercises and specific scapula stability exercises are also advisable to improve the biomechanics of the shoulder girdle.

If a tear is suspected, it is often advisable to refer patients for an MRI to ascertain the extent of the rotator cuff tear. At the Bodymotion Chiropractic and Sports Injuries Clinic EC2, we often refer patients to Vista Diagnostics in Waterloo, London

See below for scan of a full thickness Supraspinatus tear

In the case of full thickness tears, often surgery is advisable to return the injured shoulder to optimal function. If this is the case, our patients will be referred to an orthopaedic consultant and the surgical intervention is usually an Arthroscopic Rotator cuff repair whereby the torn tendon is stitched back onto its attachment to the arm bone. To see an animation of this procedure, please visit http://www.shoulderdoc.co.uk/article.asp?article=1271&section=11

At our city based chiropractic clinic, we frequently treat and rehabilitate patients after having surgery for rotator cuff tears. If you have any questions, please do not hesitate to contact our EC2 chiropractic clinic