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What is a rotator cuff rupture?


Single or more of the rotator cuff muscles / tendons (supraspinatus, infraspinatus, subscapularis) can rupture (go off) partially or completely. On the one hand, it can happen acutely, for example in a case where you receive it with your arm, or if you have a jerk in the arm. On the one hand, it can occur in older patients that the rotator cuff has degenerated, ie the circulation and elasticity of the muscle / tendon has gradually deteriorated over the years, which leads to a fragile tendon, muscle tissue that can more easily give a rotator cuff rupture.

Symptoms of a rupture in the rotator cuff


In acute rotator cuff fracture, sudden pain often occurs with difficulty in lifting and twisting the arm. Often you have pain on the front shoulder or outside upper arm. Sometimes you can experience that it snaps in the shoulder at the time of the accident. You can also feel weak in the arm. As for the older, fragile rotator cuff (degenerative), the discomfort may be reminiscent of those at  impingement  and the muscle goes off by abrasion against the overlying leg edge, acromion or by a jerk in the arm. Once the rupture occurs, there may be sudden pain and weakness in the arm. Even in this case, you can experience that it snaps in the shoulder when it happens. In some cases, it does not hurt, but it is weakness and impaired function that makes the patient seek help.


Treatment in case of rotator cuff rupture or partial rupture


Through manual examination, we can with relatively good certainty see if there has been a major rotator cuff rupture or not. With  ultrasound diagnostics  we see at the level of detail the extent of the damage, what broke and what did not. Acute total rupture of one or more tendons, is often operated on and a gradually increased training rehabilitation follows after a period of fixation of the arm into the body. The degenerative rupture is often difficult to manage with surgery. If the orthopedist has come to the conclusion that it should not be operated on, we must focus on optimizing the function of the shoulder with the remaining, functioning muscles with the help of an elevated  exercise rehabilitation .

In the case of partial ruptures where a majority of the tendon remains in place, the tendon is not operated on. To bring down pain, swelling in the shoulder can one  ultrasound-guided cortisone injection  be an option. Thereafter, or in cases where no injection is given, a gradually increased exercise rehabilitation often starts in combination with manual treatment.  

Physiotherapy at Alta Vita Physiotherapy

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