Rotator Cuff Disorders ? Surgical and Nonsurgical Treatment

Rotator cuff disorders are irritations in or damage to tendons around the shoulder. These disorders include inflammation of the tendons (tendinitis) or the bursa (bursitis), a calcium buildup in the tendons, or partial or complete tears of the tendon.

Rotator cuff disorders are irritations in or damage to tendons around the shoulder. These disorders include inflammation of the tendons (tendinitis) or the bursa (bursitis), a calcium buildup in the tendons, or partial or complete tears of the tendon.

The shoulder''s rotator cuff plays an important role in throwing movements, as in football, baseball, or softball, or racket sports like tennis. Comprised of a group of muscles and tendons, the rotator cuff allows for a large range of movement using the shoulder and also keeps the shoulder joint stable.


A rotator cuff is more easily damaged or torn as age-related degeneration develops. The factors below often occur together or overlap.
· Bones that are irregularly shaped can affect how the cuff moves in the subacromial space. You may be born with these irregularities, or they may occur after some type of injury, such as a broken bone or dislocation of the shoulder joint. If the acromion is hooked or curved, impingement or degeneration of rotator cuff tendons may be more likely.
Do I need surgery for my rotator cuff?

Rotator cuff problems, which have developed insidiously, are treated initially non-operatively with rest, analgesics, ice massage and activity modification. If the symptoms do not respond to these measures, investigations like Ultrasonogram or MRI are required to identify any tears in the rotator cuff. X-rays will not show rotator cuff, but they will show any bony abnormalities that indicate cuff disease.

When is physical therapy used to treat rotator cuff disorders?
Physical therapy is sometimes needed before surgery to help determine the cause of your shoulder problem and whether surgery may be appropriate. While strengthening a muscle that is attached to a torn tendon is unlikely to be beneficial, strengthening the surrounding muscles may allow your shoulder to compensate for a rotator cuff tendon tear. If your shoulder gets better with physical therapy, you may not need surgery. If you do have rotator cuff surgery, you will need to commit to and complete a physical therapy program after surgery.

Treatment Overview
Treatment for rotator cuff disorders focuses on relieving pain and inflammation and restoring shoulder strength, flexibility, and function. Treatment may help to prevent further complications, such as loss of strength and movement in the shoulder or additional degeneration or tearing. Treatment considerations include your symptoms, age, activity level, and whether your symptoms appear to be related to a rotator cuff injury. You and your health professional will decide together which treatment is best for you.

Nonsurgical treatment
Most rotator cuff disorders are treated without surgery. Your treatment may include:
· Resting, although gentle movement of the shoulder is recommended. Prolonged immobilization (holding the shoulder still), such as with slings or braces, may cause the shoulder joint to become stiff.
Surgery
Surgery is most useful in relieving pain and weakness in the shoulder or if the tendons are being squeezed as they move through their normal ranges of motion. The two types of surgery for rotator cuff disorders are subacromial smoothing and rotator cuff repair.

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