The rotator cuff comprises four muscles that form a cover around the head of the humerus, holding it in place and allowing the arm to rotate. The most common mechanism of injury is overuse of the tendons and muscles over a period of several years. The highest risk persons are those who perform repetitive overhead motions with their arms. The treatment varies, depending upon the severity of the tear, its location and the performance needs of the patient after recovery.
Rest
Following a rotator cuff tear, the patient will need to limit any overhead activity to allow the muscles to begin healing. He may need to wear a sling at this time to prevent any further trauma to the injured site if the tear is severe.
Medication
Nonsteroidal anti-inflammatory medications are used for controlling pain and inflammation of the injury. These are available over the counter or by prescription. A doctor may administer cortico-steroid injections directly to the injury site to control pain. These injections cannot be repeated often, because they may possible weaken the tendon.
Therapy
Physical therapy is commonly used after a rotator cuff tear. The primary goals of therapy are to increase flexibility of the rotator cuff muscles by performing slow stretching exercises and to increase the strength of the muscle group. Range of motion exercises, or stretching exercises, are either performed passively, with the assistance of a therapist, or actively, under the patient's own power. After the patient regains flexibility, strengthening exercises can commence, using tools such as elastic bands and dumbbells.
Surgery
Surgical repair of the rotator cuff tear is recommended when nonsurgical treatment does not work. It is also chosen if the tear is located in the dominant arm of an active person and maximum strength is needed after recovery. A partial tear of the rotator cuff may only require a trimming or smoothing procedure, known as a debridement.
