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What active people need to know about rotator cuff injuries

The Palm Beach Post’s “Ask the Expert” column features David W. Altchek, MD, sports medicine surgeon and founding medical director of HSS Florida, discussing the types, causes, symptoms and treatment of rotator cuff tears.

Dr. Altchek explained there are two major groups of tears, partial (some of the tendon remains attached to the bone at the tear site) or full thickness (none of the tendon remains attached). Both types can be caused by one or a combination of factors, including trauma (such as a fall), impingement from a bone spur on part of the shoulder blade (acromion), or degeneration due to tissue aging.

Symptoms of a rotator cuff tear are shoulder pain and a sense of weakness, particularly when performing overhead activities like throwing a ball. Several other shoulder conditions, including arthritis, tendonitis, and disorders of the biceps tendons can exhibit similar symptoms. Diagnosis requires an MRI scan or ultrasound, with an MRI considered the gold standard.

Dr Altchek cited most patients with partial tears can be managed with conservative treatment, such as nonsteroidal anti-inflammatory medication, cortisone injection or platelet rich plasma (PRP), and physical therapy. In contrast, people with full thickness rotator cuff tears have the best chance at remaining active with an arthroscopic rotator cuff repair. This surgical procedure is performed with regional (local) anesthesia as an outpatient, meaning an overnight stay at the hospital is not required.

This article appeared in the print edition on January 10, 2021.