Torn Rotator Cuff Classification and Treatment
What is a torn rotator cuff? Well the first thing to note is that when referring to a tear we are almost certainly talking about tendon and not muscle damage.
There are four cuff muscles and each has two tendons.
A tendon of each muscle attaches to both the scapula (shoulder blade) and the humerus (upper arm bone).
Most rotator cuff injuries are to the tendon where it connects to the Humerus.
Seldom are the tendons attaching to the scapula damaged.
Of the four tendons that can be damaged it is most often the supraspinatus tendon that is torn.
Full and Partial Tears Tears to the cuff are most often classified as full or partial tears.
This is complicated only by those rare cases when the tendon completely detaches.
Partial thickness tears often appear as a fraying of the still intact tendon.
Full thickness tears are complete "through and through" tears.
They range from small pin point sized tears to large button-hole size ruptures.
The tendon remains substantially attached to the humeral head.
As a consequence the cuff retains the majority of its function although there is often a loss of strength.
The symptoms of torn rotator cuff can be successfully treated by rotator cuff rehabilitation and rotator cuff strengthening exercises.
A tear such as those described below however will, more often, require surgery.
Worse Case Scenario! Full thickness tears can be complicated by a detachment of the tendon from the humeral head.
This will undoubtedly constrain shoulder motion.
The strength functions of the shoulder will be significantly affected.
Classification for Surgery There is a further, more specific, classification required, if surgery is being considered for a torn rotator cuff.
This is done on the basis of both the shape and the size of the tear.
These classifications are vital as they determine the correct surgical methods to be employed.
Size is a fairly obvious classification but shape, or geometry as it is known, classifies cuff injuries as follows; longitudinal, transverse, U - shaped, L shaped and reversed L - shaped.
Another important factor a surgeon will have to take into account is the general state of the damaged tendon itself.
Any degenerative changes, the degree of fat infiltration and atrophy any loss of substance.
The poorer the condition of the tendon the less chance there is of a successful outcome.
The final consideration for a surgeon will be what is known as the degree of retraction.
This is when the tendon effectively shrinks away from the site of the tear.
This is most common in a severe tear that has been left untreated for a long period of time.
If this is a major consideration it may render the tear inoperable.
To find out more, join me here torn rotator cuff.
There are four cuff muscles and each has two tendons.
A tendon of each muscle attaches to both the scapula (shoulder blade) and the humerus (upper arm bone).
Most rotator cuff injuries are to the tendon where it connects to the Humerus.
Seldom are the tendons attaching to the scapula damaged.
Of the four tendons that can be damaged it is most often the supraspinatus tendon that is torn.
Full and Partial Tears Tears to the cuff are most often classified as full or partial tears.
This is complicated only by those rare cases when the tendon completely detaches.
Partial thickness tears often appear as a fraying of the still intact tendon.
Full thickness tears are complete "through and through" tears.
They range from small pin point sized tears to large button-hole size ruptures.
The tendon remains substantially attached to the humeral head.
As a consequence the cuff retains the majority of its function although there is often a loss of strength.
The symptoms of torn rotator cuff can be successfully treated by rotator cuff rehabilitation and rotator cuff strengthening exercises.
A tear such as those described below however will, more often, require surgery.
Worse Case Scenario! Full thickness tears can be complicated by a detachment of the tendon from the humeral head.
This will undoubtedly constrain shoulder motion.
The strength functions of the shoulder will be significantly affected.
Classification for Surgery There is a further, more specific, classification required, if surgery is being considered for a torn rotator cuff.
This is done on the basis of both the shape and the size of the tear.
These classifications are vital as they determine the correct surgical methods to be employed.
Size is a fairly obvious classification but shape, or geometry as it is known, classifies cuff injuries as follows; longitudinal, transverse, U - shaped, L shaped and reversed L - shaped.
Another important factor a surgeon will have to take into account is the general state of the damaged tendon itself.
Any degenerative changes, the degree of fat infiltration and atrophy any loss of substance.
The poorer the condition of the tendon the less chance there is of a successful outcome.
The final consideration for a surgeon will be what is known as the degree of retraction.
This is when the tendon effectively shrinks away from the site of the tear.
This is most common in a severe tear that has been left untreated for a long period of time.
If this is a major consideration it may render the tear inoperable.
To find out more, join me here torn rotator cuff.
