What is the Rotator cuff? The rotator cuff is a group of muscles that move the ball of the shoulder.
Why do the rotator cuff muscles develop problems? There is one muscle in the particular that is involved, and that is the supraspinatus muscle. This muscle runs underneath a bone overhang (acromion). As we get older this bony overhang develops a sharp ridge on the underside. This ridge rubs on the muscle every time we use the arm. Initially it just irritates the muscle. Later on it will start to damage the muscle.
Because the pain is felt in the middle of the arm and not at the joint, this condition is often missed.
The first phase of the irritation is known as “Impingement”.
Once the muscle tears we call it a “Rotator Cuff tear”
If the rotator cuff (supraspinatus muscle) is not repaired soonest, it leads to more severe problems in the shoulder (Rotator Cuff Arthropathy)
How do we fix the problem? If the muscle is just irritated and the ridge is still negligible, the irritation can be reduced by physiotherapy, retraining of the muscles and a cortisone injection.
Once the ridge is so big that the muscle gets damaged (as seen on sonar), an arthroscopic removal of the ridge on the underside of the bony overhang (acromion) is indicated.
If the supraspinatus muscle is already damaged, the ridge still needs to be removed and the muscle must be repaired. If the tear is still of reasonable size it can all be done with the arthroscope (key hole surgery). Only big tears require open surgery.
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