Rotator Cuff Tear

Question 1

What are the tendons of the rotator cuff

Answer 1

SITS Supraspinatus Infraspinatus Teres minor Subscapularis

Question 2

What does the supraspinatus do

Answer 2

Abductor

Question 3

What does the infraspinatus do

Answer 3

External rotator

Question 4

What does teres minor do

Answer 4

External rotator

Question 5

What does the subscapularis do

Answer 5

Internal rotator

Question 6

What sign on examination might indicate a rotator cuff tear

Answer 6

Difficulty initiating abduction OR Humeral head rising up on abduction

Question 7

What are the causes of rotator cuff tears

Answer 7

Acute tear - trauma Degenerative tear:- Repetitive stress Lack of blood supply - blood supply to rotator cuffs decreases with age Bone spurs - on the underside of the acromion (causing shoulder impingement and over time can lead to rotator tendon tear)

Question 8

What imagine would you request for a suspected rotator cuff tear

Answer 8

X-rays - looking for bone spurs MRI or ultrasound - better for looking at soft tissue

Question 9

How can you manage a rotator cuff tear

Answer 9

Non-surgical:-

• Rest
• Avoid activities that cause shoulder pain
• NSAIDs
• Physiotherapy
• Steroid injection

Surgical:-

• Rotator cuff repair - re-attaching the tendon to the head of the humerus

Question 10

What are the complications of rotator cuff surgery

Answer 10

General:-

• Infection
• Adverse reactions to anaesthesia

Specific:-

• Permanent stiffness
• Length recovery time (sometimes)

Question 11

What are the disadvantages of non-surgical treatment

Answer 11

No improvements in strength

Size of tear may increase over time

Activities may need to be limited