Since the acromion is quite small, the upper arm has only a small area in which it is held. The rotator cuff, consisting of teres minor, supraspinatus, infraspinatus and subscapular muscles, helps the shoulder joint to gain more stability and fixes the head of humerus in the socket. The supraspinatus tendon is the tendon that ruptures most frequently, either due to degenerative changes or acute trauma.
Therapy for a torn rotator cuff
Decisive for the therapy are the tendon and the extent of the tear. It is also important to clarify possible concomitant injuries if the tendon is torn by an accident. The physician evaluates the arm’s mobility and the pain in everyday life.
After an operation, the arm is usually placed in an abduction cushion for 6 weeks and may only be moved up to 90° during this time. The most common tendon that ruptures is the supraspinatus tendon. As the tendon runs under the acromion, it is constantly irritated and fibres apart when the shoulder joint is constricted by an inflamed bursa, calcium deposits or similar constricting factors.
In most cases, pain and incipient movement restrictions are detected at an early stage and a worsening can be avoided through physiotherapy.
- If there are only minimal movement restrictions and the tear is incomplete, the doctor usually prescribes a conservative therapy. With the help of physiotherapy, movement should be carefully practiced and a strengthening of the entire shoulder joint should be achieved.
- If the patient can barely lift his arm (maximum up to 90°) and has severe pain, surgical refixation is necessary. The operation is performed by arthroscopy. Either the suture is fixed with an anchor or sutured directly, if the fibers of the torn off ends allow the suture to be sewn directly.
- In physiotherapy, gentle mobilization in the pain-free area stimulates the blood circulation in the shoulder joint, so that the inflammation or deposits are removed during the course of therapy and movement is improved.
- Likewise, traction treatment enlarges the joint space, which also stimulates blood circulation.
- Pain in the course of the musculature is treated by soft tissue techniques, transverse friction, massages or stretching according to the symptoms.
