“A muscle torn out just like a cloth tears after its worn off” , is the fundamental concept of Rotator cuff tear as eminently put forward by Dr. Gupta, a renowned name in the field of shoulder and upper extremity for past 25 years.
Imposing on what rotator cuff tear means Dr. Gupta fervently puts it as, “ an injury to the network of four tendons and muscles that connect the arm bone firmly to the shoulder socket, that are also the key factor in the movement of arm in all directions. As for the segment that is most susceptible to rotator cuff injuries, they are the ageing people and workers or sports person who are involved in heavy overhead work.”
Head, Shoulder and Hand Division, MAX Saket & Gurgaon, former Director of ‘The Hand & Upper Extremity Surgery’ at The Medanta Institute of Bone & Joint Disease, Gurgaon, Dr. Gupta feels, “difficulty in sleeping on the side of shoulder affected because of unbearable pain is the first sign that is indicative of rotator cuff tear. Thereafter the shoulder will not only feel tender on touch but also produce a crackling sound when moved.”
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Being among the first few surgeons in India who have been contributory to bringing international techniques of treatment to India, Dr. Gupta while speaking out on the methods of treatment says, “ Non surgical methods are used by orthopedics to provide relief to the patient but in case of the treatment being ineffective, surgical methods are adopted henceforth. Having performed many arthroscopic surgeries, I can affirmatively conclude that it is one of the most effective techniques of providing relief to the rotator cuff tear. Even mini open surgeries that have evolved as a newer technique, a blend of both arthroscopic surgery and open surgical repair, is being recognized as being an effective technique. We only retort to open surgeries when the damage is too vast to be repaired by other surgical methods.”
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Rotator cuff tears are dangerous enough to finish the career of a player or people who are involved in overhead work with their arms, if not treated with expertise and though they take place over a period of time sometimes an instant traumatic fall can result in it.
Relentless in his pursuance of providing relief to his patients, Dr. Gupta having one of the most skilled hands when it comes to surgeries highlights, “ After treatment it is advisory to not use the shoulder before it heals completely as it might permanently damage your shoulder.”
FAQ – Rotator Cuff Tears / Injuries
There are four tendons and muscles that govern the movement of your shoulder collectively known as rotator cuff. These muscles helps to keep your arm bone(humerus) firmly in your shoulder socket and helps to lift and rotate your arm in all directions.
When the tendons of your rotator cuff tear or get damaged partially / completely by breaking away from the bone due to an injury, it is termed as rotator cuff tear.
There are many factors that cause rotator cuff tear. As age progresses the tendons become weak and with a gradual decline become more prone to suddenly tear one day. Another factor that is contributory to rotator cuff tear is repetitive and excessive overhead work which is often observed in painters, carpenters and sportsmen who play tennis, football or baseball. Rotator cuff tear can also occur because of a fall, trying to shield a fall with your arm or lifting heavy objects.
If your rotator cuff muscles have been torn you will feel difficulty in lifting your arm above your head and moving your shoulder, your shoulder will feel tender on touch and a crackling sound will come out whenever you will move your shoulder. Sleeping on the side of the affected shoulder will become almost impossible with weakness and persistent pain, varying on the severity of your tear.
Usually rotator cuff tear is a condition that develops gradually but sometimes the tear can be instantaneous which will cause intense pain and weakness in your arm. Your doctor will conduct a thorough examination of your shoulder and arm and ask you to move your arm in all directions to check where and in how much quantum the pain and difficulty is felt by you. To confirm that your condition is related to rotator cuff tear your doctor will recommend the following diagnostic tests –X Ray with some special angle views, MRI or Arthrogram if your doctor wants to observe your condition more intrinsically.
Treatment options will vary depending on the severity of your tear, your age and your physical tenacity.
The simple treatment technique that your orthopedic will first initiate will be to put you on oral painkilling and anti inflammatory medicines and recommend you to avoid work and activities that might enhance your pain. He will also ask you to take assistance of a physiotherapist to monitor exercises that will keep your strength intact and help you to do exercise that will keep your pain under control.
If you do not get relief from the oral medication then your orthopedic might give you injections for some time but this treatment option is not followed for a long time as injections make the tendons weak.
In spite of medications and injections when there is no relief in your condition, then your orthopedic will have to take up one of the surgical methods of treatment.
Arthroscopic Repair(keyhole surgery): Your surgeon will make small cuts on your shoulder and repair your tear by using an arthroscope (small tube attached to a camera that helps the surgeon to see what is inside on a screen and then perform the surgery with the attached surgical tools)
Open Repair/Surgery: Sometimes the severity of the tear cannot be treated by arthroscopic repair and you might have to undergo an open surgery. The cut made in the shoulder measures to several centimeters in length and is performed to treat complex tears.
Mini-Open Repair: This is a relatively newer technique which is a combination of both arthroscopic repair and open surgery. Your surgeon will look into your rotator cuff damage by arthroscope and do the essential bit and then will conduct a surgery to repair whatever could not be repaired by arthroscopy.
You can return to your normal day functioning after surgery depending on your healing and severity. Still it will be advisable to start work or any other strenuous activity only after 2 or more months. In case of any issues you can always consult your orthopedics.
- Frozen Shoulder
- Shoulder Dislocation / Shoulder Instability
- Rotator Cuff Tears / Injuries
- Scapula Fractures
- Shoulder Replacement
- Impingement Syndrome
- Proximal Humeral Fractures
- Clavicle Fractures
- Loose Body Removal
- Synovial Biopsy / Synovectomy
- Slap Injury and Repair
- AC Joint Injury
- PASTA Lesion and Repair
- Hand and Wrist Fractures
- Carpal Tunnel Syndrome
- Basal Joint Thumb Arthritis
- Distal Radius Fracture
- Scaphoid Fractures
- Radial Club Hand
- Rheumatoid Arthritis
- Metacarpal Fractures
- Giant Cell Tumors (GCT) Tendon Sheath
- Phalangeal Fractures
- Congenital Trigger Thumb
- Radial Nerve Injury
- Median Nerve Injury
- Extensor Tendon Injuries
- Flexor Tendon Injuries
- Ulnar Nerve Injuries
- Nerve Injuries Finger
- Mallet Finger
- Thumb Extensor Tendon (EPL) Rupture
- Dupuytren’s Contracture /Disease