Rotator cuff tears

The rotator cuff is a muscular group that ensures mobility and stability of the shoulder by centering the humeral head in front of the glenoid of the scapula. The muscles are bound to the bones by tendons and, when these are torn due to trauma or wear of your joint, your shoulder no longer functions properly.

The mobility and stability of your shoulder are ensured by the combined action of different muscles that constitute the rotator cuff, so-named as these muscles come in a way "cap" the head humeral.

When the tendons, which tie the muscles to the bones of your joint, are damaged, the normal function of your shoulder is difficult.

The humeral head can no longer rotate properly around its center of rotation, it may tend to rise and come in contact with the acromion, creating a subacromial impingement.

Some patients are more hampered by functional limitation, others by pain, but this is not related to the severity of your condition : some massive ruptures can be relatively painless while more superficial inflammations can be more painful.
There are different stages of severity in rotator cuff tears : partial or superficial tears, which do not penetrate the tendon, and complete or transfixing tears.

Below, an animation to better understand the mechanism of rotator cuff tear (in French)

Treatment options

The treatment will depend on the severity of the lesions but also the use you make of your shoulder as in your professional, sport or leisure practice.
To establish an effective diagnosis your surgeon will need an X-ray as well as an ultrasound or MRI to assess the condition of the tendons.

Medical Treatments

In first instance, pain and inflammation can be controlled by analgesics and anti-inflammatories medications. Appropriate rehabilitation will also help to restore shoulder flexibility and develop compensations for other unreached muscles. These medical treatments can sometimes suffice to relieve you durably ; nevertheless a torn tendon cannot heal naturally.

Surgical Treatment

The first operative stage consists in releasing the acromial space, the second time in repairing the damaged tendons.

At the Bordeaux-Merignac Sport Clinic, rotator cuff repair is performed under arthroscopy and on outpatient basis.

When cuff tears cannot be repaired because they are too old, too wide or too retracted, the surgical procedure of subacromial decompression under arthroscopy, can relieve the painful phenomena linked to the subacromial impingement.

In all cases appropriate rehabilitation should be conducted with seriousness and motivation to achieve the best possible long-term outcome

Below, an animation to better understand the surgery procedure (in French)