In this video, Shoulder Specialist Dr. J. Michael Bennett talks about rotator cuff injuries. This is the second in a series of five videos covering common shoulder injuries. Dr. Bennett primarily specializes in treating injuries and pathologies of the shoulders, elbows, and knees.
Dr. Bennett is a Board Certified Orthopedic Surgeon and a Fellowship Trained Sports Medicine Specialist with offices in Sugar Land near First Colony Mall and in Houston near the Galleria. You can make an appointment at our Sugar Land office by calling 281-633-8600 or you can call our Houston office at 713-234-3152.
This is the second video of a five-part series on shoulder injuries.
– Number two is an actual injury of the rotator cuff. It may seem similar to a bursitis impingement type of scenario with pain, particularly with raising your arm above your head.
After that, they were still functional and then the next day they woke up in severe pain and noticed the pain got worse, and they were unable to have
adequate strength above their head. What that usually means is that this rotator cuff which is in the green right here, is disrupted and you get a tear.A lot of times, it has to do with the history and how it happened, the mechanism of injury. So a lot of times when people come in who have rotator cuff problems, they say, they were working out at the gym, they were lifting something heavy and they felt a pop or a snap or even had a tearing sensation in their shoulder.
That tear can be either a full thickness tear, meaning all the way through the tendon down to the bone. Or it can be a partial tear just involving a portion, a partial, a part of the tendon and not necessarily going all the way through the bone.
Now how that gets treated is very different, a partial tear of the rotator cuff versus a full thickness tear. And also we’ll be looking to take into consideration is patient’s activity, age, and their expectations.
If you have a full thickness tear, the problem with the full thickness rotator cuff tears is that they can get progressively get worse. They can get larger, particularly if you’re doing a lot of activities and you’re an active individual. Those tears can progress and propagate. And sometimes they can retract.
That tendon is like a rubber band. Once you snap that tendon off of the bone and it becomes torn, that tendon retracts immediately. What that means is that you start to lose coverage over that ball. Once that ball loses its coverage from the tendon and it retracts, this muscle over here kind of bunches up and becomes what we call, atrophic, meaning it’s become fatty-infiltrated or become very weak and scar tissue-like.
So it becomes very difficult to pull that tendon all the way back down and reattach it back down to the bone, if you decided to proceed with surgery to fix it. There is a window of opportunity when that tendon is very pliable and actually has good excursion and you can actually pull that tendon down and reattach it.
There are also a lot of factors that come into play regarding if you can fix rotator cuff injuries. And like I mentioned before, activity, status, age, and also quality of tendon makes a big difference too. And the age of the tear will determine whether or not you’re a candidate for having this fixed.
Partial tendon tears are another big issue, and that will be a little bit more subtle than full thickness tears. Those patients can still raise their arm above their head, but they may have this chronic dull aching pain, particularly when they raise their arm above their head, in addition to severe night pain.
Night pain is very common in rotator cuff injuries. You may be laying there doing nothing and you’re having severe shoulder pain. That is a good indicator that there is something going on with the rotator cuff.
A partial tear is when the tear does not go all the way through the tendon. And often times a partial tear can actually respond very well to conservative measures like an injection or even physical therapy.
So in treating rotator cuff injuries, it’s very important to determine what type of tear you have. Many times a physician can do that or give you that diagnosis via ultrasound or MRI, based on that physician’s test of choice. And then they will treat you accordingly.
The longer you wait to get your shoulder evaluated by a shoulder specialist, the more likely it is that conservative treatments or minimally-invasive treatments won’t work. Set yourself up with a treatment plan to return to your full activities.
Call Dr. Bennett for an evaluation at 281-633-8600 for the Sugar Land clinic and 713-234-3152 for the Houston clinic.
Dr. Bennett has also created a portfolio of patient education videos about shoulder injuries and treatments.