Rotator cuff shoulder injuries in sports are usually a result of microtrauma from repetitive movements. For competitive or recreational athletes involved in baseball, tennis, or swimming, shoulder disorders – especially rotator cuff injuries – can be debilitating and cause significant disabilities. Therefore, prompt diagnosis and treatment can improve symptoms profoundly.

The rotator cuff is a group of four tendons that combine to provide normal functioning and stability in the shoulder. Each of the tendons connects a muscle in the shoulder blade as part of the upper arm bone.

“In the past, men and women younger than age 40 were more likely to have partial thickness tears, which are easier to repair,” says Kevin Plancher, MD, a leading Manhattan orthopedic surgeon and sports medicine specialist and head of Plancher Orthopaedics & Sports Medicine PLLC in New York City.

“Older people, with full thickness tears, were less likely to have their shoulder fully repaired – the key is the size and quality of the tendon tissue that is found in the damaged shoulder. Now, a new technique known as the 'arthroscopic rotator cuff repair' uses a small incision demonstrating excellent results, in older people and those with difficult problems,” Plancher says.

As people age, the muscle and tendon tissue of the rotator cuff loses some elasticity, becomes more susceptible to injuries and is often damaged while performing everyday activities. This is the reason why rotator cuff tears are more commonly seen in the elderly. In younger patients, damage is caused by either a traumatic injury, or the patient is demanding unusual use of their shoulder, as is the case in professional athletes.

“By utilizing the arthroscopic approach,” Plancher adds, “there is significantly less associated trauma than with a traditional 'open' rotator cuff repair or even 'mini-open' approach."

For the arthroscopic procedure, the patient is brought into a surgicenter or hospital on an outpatient basis. Regional anesthesia allows the patient to go home more comfortably without the need for general anesthesia.

Several small holes – less than 1 cm – are made around the shoulder. Using a camera and video screen, the rotator cuff is manipulated and repaired back to the bone where it tore off. Sutures with a wire core center are used and patients are placed in a sling post operatively. Most patients can expect to return to sports three to four months after surgery.

Source: Plancher Orthopaedics and Sports Medicine