The rotator cuff is made up of a group of muscles and tendons that surround the shoulder and are essential to its movement, strength and stability.
Injuries can appear through trauma, sporting activity, repetitive movements or degenerative changes over time. They can cause pain, loss of strength and difficulty lifting or moving the arm, affecting daily, work and sporting activities.
Treatment depends on the type of injury, its size, the symptoms, age, activity level and the needs of each patient.
In many cases it starts with conservative management, which may include rehabilitation and physical therapy, temporary modification of certain activities and treatment to control pain. In selected patients, orthobiologic therapies or focused shockwave therapy may also be considered, depending on the diagnosis.
When there is a significant tear, loss of function or an injury that does not respond adequately to conservative treatment, surgical treatment may be considered.
Evaluation and treatment is provided for various conditions related to the rotator cuff, including:
When surgery is indicated, many injuries can be treated by shoulder arthroscopy, a minimally invasive technique that uses small incisions and a camera to visualize the joint.
During the procedure, the surgeon can repair the injured tendon and reattach it to the bone when the characteristics of the injury allow it.
Afterwards, rehabilitation plays an essential role in protecting the repair and progressively recovering the mobility, strength and function of the shoulder.
Not every rotator cuff injury needs surgery. The choice of treatment is made after a specialist evaluation and analysis of the imaging studies, seeking the most appropriate option for each patient.
The most common symptoms are shoulder pain, especially when raising the arm or performing certain movements, pain at night, loss of strength and difficulty with daily activities. A definitive diagnosis requires a medical evaluation and, in some cases, imaging studies.
No. Many injuries can initially be treated with physical therapy, rehabilitation and other conservative measures. Surgery is considered depending on the type and size of the tear, loss of strength or function, the patient's age and activity, and the response to previous treatments.
It depends on the type of injury. Some partial tears can improve clinically with conservative treatment, although the tendon does not necessarily recover its original anatomy. Complete tears generally do not heal back to the bone spontaneously, so each case must be evaluated individually.
In certain patients and injury types, Platelet-Rich Plasma (PRP) may be considered as part of the treatment. Its indication depends on the diagnosis and it does not replace a surgical repair when one is necessary.
It may be indicated in certain shoulder tendinopathies, especially in some cases of calcific tendinopathy. It is not the appropriate treatment for every rotator cuff injury, so the diagnosis must be established first.
It may be considered for traumatic tears, significant injuries, major loss of strength or function, or when symptoms persist despite adequate conservative treatment. The decision depends on the particular characteristics of each patient.