Rotator cuff tear

Pathology
The rotator cuff is a group of tendons that stabilize the shoulder and enable its movements. Disorders may include tendinopathy, inflammation, or a partial or complete tear of one or more tendons.

This condition may be related to aging (degeneration), repetitive microtrauma (overhead activities), or an acute injury.

Typical symptoms include shoulder pain, often worse with movement, weakness, reduced mobility, and sometimes night pain.

Examination
Diagnosis is based on clinical examination and imaging.

X-rays can assess the subacromial space and detect bony abnormalities. Ultrasound or MRI allows visualization of the tendons and confirmation of a lesion or tear.

Treatment

Non-surgical treatment
Treatment is usually conservative:

• relative rest and activity modification
• physiotherapy to strengthen muscles and improve mobility
• analgesics and anti-inflammatory medication if needed
• corticosteroid injections in selected cases

Surgical treatment
In case of persistent pain or significant tear, surgery may be considered:

• arthroscopic tendon repair
• subacromial decompression in selected cases

Recovery
The outcome depends on the severity of the condition.

After surgical repair, recovery is gradual and may take several months, with essential rehabilitation. Most patients experience improvement in pain and shoulder function.

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