The shoulder is made up of three bones: the humerus (upper arm), the scapula (shoulder blade), and the clavicle (collar bone). It is the most mobile joint in the body. The shoulder compromises stability for this increased mobility which makes it prone to injury.
The rotator cuff is made of four muscle (Supraspinatus, infraspinatus, subscapularis, and teres minor) that form tendons and help hold the ball in the socket to provide a dynamic stability to the shoulder. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm. Most tears occur in the supraspinatus muscle and tendon, but other parts of the rotator cuff may also be involved.
In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object. There are two different types of tears; 1)Partial Tear: This type of tear damages the soft tissue, but does not completely sever it. 2)Full- Thickness Tear: This type of tear is also called a complete tear. It splits the soft tissue into two pieces. In many cases, tendons tear off where they attach to the head of the humerus. With a full-thickness tear, there is basically a hole in the tendon.
There are a couple of ways the tendon tears; one is an acute trauma and the second is by degenerating. Traumatic tears are caused by a fall on an outstretched arm or lifting something heavy in a jerking motion. Degenerative tears occur from repetitive stress such as throwing a baseball or continuous work over head like an electrician, lack of blood supply, and development of bone spurs.
IF greater than 50% of tendon is torn the best course of action is to undergo a rotator cuff repay. This can be done arthroscopically or open depending on the size of the tear. Surgery involves reattaching the tear to the humerus. You may have other shoulder problems in addition to a rotator cuff tear, such as osteoarthritis, bone spurs, or other soft tissue tears. During the operation, your surgeon may be able to take care of these problems, as well.
Physical Therapy is a vital component of recovery. Depending on the size of the repay, your surgeon will refer you to therapy within in 1-6 weeks following surgery. Physical Therapy will first begin to address your ROM to prevent adhesive capsulitis (frozen shoulder). Regaining your motion is the most important part of the rehabilitation process during the first 8 weeks. As you progress, the Physical Therapist will being with passive exercises progressing to more active movement around 8-12 weeks depending on the severity of the injury. Rehab is a slow process but is essential to recovery. Physical Therapy last 4- 6 months. Returning to sports will be anywhere from 6-9 months.