Huw David

Rotator Cuff Shoulder Injuries

The rotator cuff is a confluence of tendons that passes from the shoulder blade to the top of the arm bone or humeral head. It serves to both stabilise the shoulder joint and initiate movement. Inflammation of the rotator cuff is referred to as subacromial impingement and gives rise to activity related discomfort. In time, the rotator cuff may fail with fibres of the tendon becoming detached from the humeral head progressing from a partial thickness to a full thickness defect or tear of the tendon. Tears of the rotator cuff can occur following a fall or wrenching injury though they can occur just as commonly without any obvious proceeding event. Unfortunately, such tears will not heal spontaneously though there is much ongoing debate as to the best treatment for such injuries and it is recognised that not all patients will require surgery to repair the damaged tendon. However, certainly in younger individuals an attempt is usually made to repair the defect and with evolving arthroscopic techniques this is something that can often be performed with keyhole surgery.



Larger tears of the rotator cuff may be associated with muscle wasting and scarring. Patients with a large cuff tear are often troubled by weakness as much as pain and will typically try to either favour their other arm or support the affected arm when undertaking certain tasks or manoeuvres.

Based on a full history and thorough clinical assessment Huw will be able to diagnose your problem. By using additional investigations such as an ultrasound scan or MRI, it will be possible to establish whether or not the tendon is torn and the extent of the damage. He will then be able to discuss with you the various treatment options, ranging from physiotherapy with or without an injection through to surgery.