Located in the shoulder, the rotator cuff is made up of four muscles that work together, propelling the shoulder through its wide range of movements. Ligaments and muscles are placed along the humerus (arm’s long upper bone) in such a way that both the arm and the hand can swivel, arc, and rotate along the axis. The significance of this is key, and generally underappreciated. For instance, very few sports can be played without the rotator cuff. Because of this, injuries to it are taken very seriously.
Most Rotator cuff injuries are injuries to the tendon, occurring where it inserts itself into or connects to the bone. Some are partial tears that can involve actual muscle, while a complete tear usually indicates that there is a disruption in the tend attachment. These muscles are attached to the scapula, which is the wing-bone of the back. They are able to swing over the shoulder. There are more important muscle-tendon attachments, including those to the collarbone as well as bony side-projections located on the upper part of the spine. The brain coordinates all of the muscle tensions that make the arm move.
Causes of Injury
In young people, rotator cuff tears are most often caused by falling on top of an outstretched hand, when the shoulder receives a direct hit, or by an unusual event such as a car accident occurring on the side. The injury is most often accompanied by extreme pain, the source of which the patient can find difficult to locate. Oftentimes, the patient will only know the pain they are experiencing and that they are unable to use their arm. She only knows that the pain is severe and the arm is nearly useless. Most injuries of this type happen to older people because the tendons get thinner as we age, and are therefore much more prone to injury and breaking. In some elderly people, the rotator cuff can even be torn by repetitive movements, such as dealing with high cabinets in the kitchen or brushing hair.
Treatment varies based on the age of the patient, as well as the severity of the injury. In elderly patients, treatment is often conservation and uses a combination of anti-inflammatory drugs to reduce swelling with physical therapy for strengthening muscles that are still intact. Another common treatment is injecting steroids into the injured area, which can relieve pain for weeks. When the patient is young, surgery is usually needed to avoid the long-term disability that would come with a bad shoulder, even more so when the dominant arm has been injured. A diagnosis to see if there has been a tear is usually made using an MRI. When the surgery is performed, it can be done using either large or small incisions. Larger incisions make the surgery easier to perform, as smaller incisions make using cameras and scopes a necessity. The large incisions are almost always used in older patients as well, due to the spurring of bones that develop as we age, and even this is only used on those with extremely high pain levels or who have lost almost all use of the arm and are not responding to other treatment methods. After the procedure, the recovery period lasts six months or longer, including in younger patients. Over these months physical therapy is typically used with increasing intensity to rebuild the shoulder muscles and make it stronger. Not pushing the limit on what you can do is key in these first few months. For younger patients, a rotator cuff injury that is correctly diagnosed and then repaired heals perfectly, and a return to completely normal arm use is typical. However, if the diagnosis is delayed by a significant amount this complete repair may not be able to happen, as the involved tendons and muscles will atrophy as time passes. Aggressive diagnosis and repair is extremely important with this type of injury, and increasingly more so when the patient is young.
Contact a Lawyer About Torn Rotator Cuff Injury
If you have suffered a torn rotator cuff as a result of a car accident, or negligence of others, Parker Scheer recommends that you consult with a personal injury lawyer and evaluate your case. For your free confidential case review click here and receive a response from one of our attorneys within hours. If you prefer, you can also telephone our offices in Boston seven days a week at toll-free.