Inside the shoulder joint there is a muscle group consisting of four muscles: subscapularis muscle, supraspinatus muscle, infraspinatus and teres minor muscle, which surround the head of the humerus from above like a cap. The function of these muscles is to both stabilise the shoulder joint and to lift and turn or rotate the arm. These muscles are therefore grouped, according to the function, and called theRotator Cuff
If you look at the osseous channel through which these muscles run, you can easily see that on exertion, damage to the muscle tissue occurs (see also impingement).
As a result of an acute injury, a rupture of the rotator cuff can occur (rotator cuff lesion). Increasing wear and deterioration, however, is significantly more common in the context of impingement syndrome. The supraspinatus tendon (i.e. the supraspinatus muscle tendon) is the most frequently affected in this situation.
Pain when lifting the arm, often linked with a significant loss of strength is typical in rotator cuff injury. Under certain circumstances, the arm cannot be lifted at all.
In the case of younger patients, a rotator cuff injury should be treated surgically. In most cases, the tear in the rotator cuff is closed in a minimally-invasive manner in the context of Arthroscopy . This means that a scar of only three to four millimetres results. In the case of larger or older injuries, this may not be possible and a skin incision measuring approx. one centimetre is necessary. It is important to mention during the patient discussion that, despite undergoing an operation, pain will persist for eight to twelve weeks and intensive postoperative physical therapy is required.
In the case of elderly patients, three to six months of conservative treatment with physiotherapy can be attempted first. However, as very good results are achieved in general with the current surgical methods, an operation should not be delayed for too long in older patients who complain of persisting pain and restriction of movement that is disruptive despite physiotherapy.
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