A tear in the tendon of the inner shoulder muscle (rotator cuff) can occur following an acute injury or it can arise as a gradual process over a longer time period. The tendon can tear away from the bone to which it is attached, causing pain in the shoulder. This pain is often felt in the upper arm and can be severe enough to disturb sleep. It can also make movement above shoulder height difficult because of the pain and (in some cases) weakness. The condition can usually be diagnosed by a specialist shoulder examination. An ultrasound scan (click to read more) is used to confirm the diagnosis and to guide a steroid injection into the torn tendons. This may give temporary or permanent relief. Physiotherapy is also useful in this condition.
If the pain returns after the steroid injection and physiotherapy, then a keyhole or open surgical repair of the tendons may be required in order to give a more permanent solution. This procedure, whereby the tendon is re-attached to the bone, is called a rotator cuff repair (click to see an animation about the surgery). The procedure uses a metal anchor that is located in the bone, the sutures attached to the anchor being tied through the tendon. The ExeterShoulder surgeons have carried out and published research into the techniques of rotator cuff repair and currently each perform around 60 of these procedures every year. It usually takes around 3-6 months to fully recover from the operation(click to read more about recovery). Occasionally the tendons are not repairable due to the size or severity of the tear. In this situation patients may benefit from a keyhole operation on the joint or they may require a shoulder replacement.