What is the Rotator Cuff?
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint. They are responsible for both rotating the arm and stabilising the humeral head during all shoulder movements.
Types of Rotator Cuff Tears
Partial Thickness Tear
The tendon is damaged but not completely severed. Depending on the size and the patient's activity level, may be managed with physiotherapy, PRP injection, or in some cases arthroscopic debridement.
Full Thickness Tear
The tendon is completely torn. Small full-thickness tears in older, low-demand patients may be managed conservatively. Larger tears causing significant weakness in younger active patients generally require surgical repair.
Surgery vs Physiotherapy Decision
Factors favouring surgery: age under 60 · significant weakness · large tear · traumatic tear · failure of 3-6 months conservative treatment. Factors favouring conservative: small partial tear · older patient · low demand · medical comorbidities.
Recovery Roadmap
- Week 1-6: Arm in sling — protecting the repair. Gentle pendulum exercises.
- Week 6-12: Passive physiotherapy — someone moves your arm for you. No active use.
- Month 3-4: Active physiotherapy begins — rotator cuff strengthening.
- Month 4-6: Progressive strengthening, return to light work.
- Month 6-12: Full return to sport and heavy activities.
The repair takes 3-6 months to biologically heal into bone. Rushing this process risks re-tear — the most common complication of rotator cuff surgery.
🎬 Rotator Cuff Surgery — Dr. Sumit Dubewar
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