ROTATOR cuff injuries are common in athletes who engage in overhead sports such as baseball, tennis and swimming and in older adults who may experience degenerative changes in the shoulder joint.
The person will start to experience worsening shoulder pain which does not resolve with rest, reduced range of motion on the affected shoulder and worsening pain, especially at night which affects sleep.
They won't even be able to perform daily activities using the affected arm.
Pantai Hospital Ampang (PHA) consultant orthopaedic, trauma and sports arthroscopic surgeon, Dr Sabbir Ahmad says the rotator cuff comprises four muscles, each with a tendon that links to the upper arm bone (the humerus).They are located around the shoulder joint and work together to provide stability and movement to the shoulder.
Racket sports with plenty of overhead motion tend to cause more injuries of the rotator cuff.
Dr Sabbir says due to the nature of rotator cuff tears and poor healing potential under repeated stress, pain may worsen over time and continuing to play games, especially racket games or contact sports, may not be possible.
"Aggressive movements on the affected arm will worsen pain and affect sports performance too."
AGE A FACTOR
Rotator cuff injuries can also be degenerative in nature because as we age, the tendon weakens and there may be impingement from the surrounding bones which cause tears to occur.
Dr Sabbir says degenerative causes of rotator cuff tears stem from years of overuse, poor vascularity over time of the tendons, partial tears due to trauma left untreated and bone spurs which rub against the tendon and cause tears over time.
"Diabetes and obesity can also cause weakening of the tendons leading to rupture of the tendons."
Frozen shoulder and rotator cuff tears exhibit similar symptoms. However, the differentiating sign is how the shoulder moves.
A frozen shoulder limits the range of shoulder motion for the patient. As a result, when the doctor attempts to move the arm, it may not move beyond a specific point.
"On the other hand, with a rotator cuff tear, the patient can lift his hand manually beyond specific points even though he might experience difficulty and pain."
Dr Sabbir adds that adults of all ages can have rotator cuff surgery if required.
However, elderly patients with multiple comorbidities will need to be screened to ensure they're stable enough to undergo the procedure.
The operation is done arthroscopically and hence the risks of bleeding and infection are minimal.
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