• The shoulder muscle is involved in activities of daily living."My ruptured tendon" is Copyrighted by Flickr user: juhansonin (Juhan Sonin) under the Creative Commons Attribution license.
  
  

What are the Rotator Cuff Muscles?

• The rotator cuff is composed of four muscles, the supraspinatus, infraspinatus, subscapularis and teres minor, which are responsible for stabilizing the shoulder within its joint when lifting and rotating the arms. These muscles keep the upper arm bone called the humerus intact within the shoulder joint. The rotator cuff muscles are vital in providing dynamic stability to the shoulder joint during rotation and arm lifting. Any tear or injury to this muscle groups can result in significant restricted range of motion of the shoulder.
  
  

Causes of Rotator Cuff Injury

• Rotator cuff injury is a common muscular injury sustained with a history of repetitive overhead motion of the shoulder. It is a common muscular condition among athletes involved with sports such as tennis, rowing, weightlifting and baseball. The tear from this muscle group may also be due to acute trauma on the shoulder area. It is also common among individuals over 40 years of age due to overuse.
  
  

Rotator Cuff Injury Symptoms and Surgical Treatment Options

• Pain during shoulder motion is the initial manifesting symptom of a rotator cuff tear. With partial muscular tear, there is a limited degree of shoulder range of motion, a condition called a painful arc syndrome. A complete tear will result in the inability of lifting the arms. There is often a resulting muscular weakness and the pain is often recurrent and constant, especially during the night. This can affect the patient's quality of sleep.
  The American Academy of Orthopedic Surgeons indicates two treatment approaches to rotator cuff tears: surgical and non-surgical. The non-surgical approach is a conservative treatment involving limitation of shoulder movements that elicit symptoms. This form of treatment is suited for minimal tears only, and physical therapy usually suffices to restore the shoulder range of motion. Surgery is indicated for conditions that do not respond to conservative treatment with associated loss of function, significant muscle weakness and limited range of motion.
  
  

Surgical Treatment Approach to Rotator Cuff Injury

• Surgical approach to rotator cuff tear involves arthroscopy with a small or larger incision and open surgery. Arthroscopy may involve less than a centimeter incision (small) or between four to five centimeters incisions (large). Open surgery involves an incision length between 10 to 12 centimeters to trim and remove unhealthy tendons. The primary goals for surgery is to repair the tear, reattach tendons to the bone, restore function and provide comfort.
  
  

Post Surgical Pain Management of Rotator Cuff Injury

• Pain management is a part of post-surgical care among individuals with rotator cuff tears. Although intravenous pain medications are used immediately post surgery, oral pain medications such as hydrocodone or Tylenol usually suffices to manage occasional pains a few days after the surgery.
  
  Recovery is often seen three months after surgery. The patient will need to undertake physical therapy immediately after surgery to prevent stiffness and scarring on the surgical incision which are the usual cause of pain. The rehabilitation treatment involves passive movement of the shoulder followed by an assisted to active shoulder range of motion done by the patient. Stretching exercise is then initiated at six weeks post surgery to prevent pain and increase the shoulder range of motion.
  
  At three months after the surgery, strengthening exercises such as shoulder movement with weights are done. Better progress is seen by three months postsurgery. The patient's shoulder mobility improves, and, with consistent physical therapy, pain becomes manageable.
  
  Cryotherapy such as cold compress may be applied to provide pain relief. Most of the physical therapy managements provided after surgery of rotator cuff tears are tailored to prevent pain and to restore the shoulder's normal range of motion.