Which tendon is most frequently affected? | Torn rotator cuff

Which tendon is most frequently affected?

The rotator cuff consists of a total of 4 muscles: Musculus infraspinatus, musculus supraspinatus, musculus subscapularis and musculus teres minor.If the rotator cuff is torn, the tendon of the supraspinatus muscle is most frequently affected. The reason for this is the anatomical position of the tendon. The tendon runs directly between the acromion and the head of the humerus.

As soon as there is a small narrowing of this space, the tendon can be affected. Since this is very often the case in the context of inflammation of the bursa, injuries or degenerative changes, for example, the tendon of the supraspinatus muscle is considered to be very susceptible to irritation that results in a tear. Classically, a rupture of the supraspinatus tendon can be detected by an abduction inhibition of the arm. The function of this muscle, namely abduction or abduction of the arm in the shoulder joint, is not maintained in the event of a tear.

Can a torn rotator cuff heal on its own?

Without conservative or surgical measures, self-healing of a rotator cuff tear is unlikely. To regain full functionality and load capacity, torn parts are surgically reunited. With purely conservative therapy, this goal of reunification can no longer be achieved, so that movement and stress can be restricted.

If a tear in the rotator cuff is left to itself, only symptoms such as pain can be reduced. A restriction of movement or a loss of strength will remain, since the torn parts will not rejoin on their own. Effectively, pain may be reduced over time without therapeutic measures – but the arm and shoulder joint will have to lose functionality and mobility.

How long will I be sick or unable to work with a torn rotator cuff?

The length of a sick note or incapacity to work depends on the severity of the tear, the type of therapy and, to a large extent, the profession. As a rule, the rotator cuff tear is treated surgically to completely restore functionality and load. This means that the arm must first be immobilized 4-6 weeks after surgery.

In most cases, physiotherapy is already started during this time to avoid stiffening due to the immobilization. This may be followed by several weeks of rehabilitation. Depending on whether the person affected only has to work in an office with minimal strain on the shoulder and arm or is employed in physically active professions such as construction workers or craftsmen, the duration of the sick leave or incapacity to work varies.

In the case of purely office jobs, it amounts to 2-3 weeks. Since a torn tendon can take up to 4 months to heal completely, a sick note or incapacity to work is issued for a period of 3-4 months for physically demanding jobs. A rotator cuff tear can occur at very short notice due to trauma, but also due to long-term damage lasting for years.

Initially, only a small tear may occur, which continues to tear over several weeks until it becomes painful and causes problems. After a tear it can be assumed that no matter whether surgery or conservative treatment, 6 weeks must be planned during which no active movement at all may be performed. Only after 6 weeks may you slowly start moving yourself again.

But even then no heavy work may be carried out or heavy weights lifted. Some patients are fit for use again after 3-4 months. Others have complaints and pain for years and are not fully functional.

What they have in common, however, is that sports and jobs that put a strain on the shoulder may only be fully functional again after about half a year. And even then, it is essential to consult with the patient if pain occurs.