Rotator cuff injury

Question 1

What can cause rotator cuff tears?

Answer 1

May be related to overhead activities e.g. tennis or overhead construction work

Acute injury e.g. fall onto outstretched hand
Degenerative changes

Question 2

Rotator cuff muscles and their function

Answer 2

S – Supraspinatus – abducts the arm
I – Infraspinatus – externally rotates the arm
T – Teres minor – externally rotates the arm
S – Subscapularis – internally rotates the arm

Question 3

Presentation of rotator cuff injury

Answer 3

Shoulder pain

Weakness and pain with specific movements relating to the site of the tear (e.g., abduction with a supraspinatus tear)

Question 4

Investigations in suspected rotator cuff tear

Answer 4

X-ray not useful for diagnosis, but can exclude bone pathology e.g. OA

Ultrasound or MRI can diagnose rotator cuff tear

Question 5

Management of rotator cuff tears

Answer 5

May be conservative - esp if increased risk of surgery

Active, young or full thickness tear - surgery ( arthroscopic rotator cuff repair - tendon reattached to bone (keyhole surgery)

Non-surgical options:
Rest and adapted activities
Analgesia (e.g., NSAIDs)
Physiotherapy