Injuries to the rotator cuff

Rotator Cuff Injuries — What Treatment Options Are There?

Inju­ries to the rota­tor cuff, a ten­don pla­te con­sis­ting of 4 ten­dons on the should­er joint, are based on a wear-rela­ted pro­cess. As a result, the­se ten­dons tend to tear with incre­asing age, which is then expres­sed in sym­ptoms (e.g. pain and rest­ric­ted mobi­li­ty). If con­ser­va­ti­ve the­ra­py using phy­sio­the­ra­py (inclu­ding manu­al the­ra­py) is unsuc­cessful, the arthro­sco­pic (“key­ho­le tech­ni­que”) suture is suc­cessful­ly used.

Symptoms and course:

An inju­ry to the rota­tor cuff is usual­ly initi­al­ly wit­hout sym­ptoms (asym­pto­ma­tic). Howe­ver, a decom­pen­sa­ti­on is obser­ved over the cour­se of time, whereu­pon tho­se affec­ted com­plain about load-depen­dent pain and a reduc­tion in move­ment and strength (espe­ci­al­ly when moving abo­ve should­er level). In addi­ti­on, the­re are occa­sio­nal night pains. Sin­ce it is a dege­ne­ra­ti­ve pro­cess, the sym­ptoms gra­du­al­ly increase if left unt­rea­ted. This is main­ly becau­se the seve­ri­ty of the inju­ry increa­ses wit­hout ade­qua­te therapy.


The dia­gno­sis is based on a detail­ed, stan­dar­di­zed phy­si­cal exami­na­ti­on. In the fol­lo­wing, X‑rays and magne­tic reso­nan­ce ima­ging (MRT) are used to con­firm the suspec­ted dia­gno­sis or to sup­port the the­ra­py. An ultra­sound scan can also help to eva­lua­te the pro­gres­si­on of a ten­don injury.

Therapy and follow-up treatment:

Con­ser­va­ti­ve as well as ope­ra­ti­ve the­ra­py opti­ons are available depen­ding on the seve­ri­ty of the ten­don inju­ry. The choice is always based on seve­ral pati­ent- and inju­ry-spe­ci­fic fac­tors and is to be sel­ec­ted after con­sul­ting the per­son con­cer­ned after loo­king at all the fin­dings. If con­ser­va­ti­ve the­ra­py is unsuc­cessful, sur­gi­cal the­ra­py is indi­ca­ted. This is done in our depart­ment in a mini­mal­ly inva­si­ve man­ner (arthro­sco­pic, key­ho­le tech­no­lo­gy). If the ten­don is torn, the inju­red ten­don is reat­ta­ched to the hume­rus (head of the hume­rus) using so-cal­led suture anchors. The fol­low-up tre­at­ment depends hea­vi­ly on the sur­gery cho­sen. In all cases, the affec­ted arm is immo­bi­li­zed in a should­er brace. The dura­ti­on of the immo­bi­liza­ti­on is bet­ween 1 and 6 weeks. This is recom­men­ded indi­vi­du­al­ly by the sur­ge­on. The affec­ted should­er joint can be prac­ti­ced phy­sio­the­ra­py imme­dia­te­ly after the operation.

Leave a Reply