It is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the scapula or shoulder blade. The four muscles that comprise the rotator cuff are the supraspinatus, infraspinatus, teres minor and subscapularis muscle. The contraction of each of these four muscles produces a different movement due to where their tendons insert. Supraspinatus: This muscle originates at the supraspinous fossa of the scapula and inserts into the greater tubercle of the humerus. It helps the deltoid abduct the humerus. Infraspinatus: Originating at the infraspinous fossa of the scapula, this muscle inserts into the greater tubercle on the humerus. It laterally rotates the humerus. Teres minor: This muscle originates at the lateral part of the scapula and inserts into the greater tubercle of the humerus. It adducts and laterally rotates the humerus. Subscapularis:Originating at the subscapular fossa, this muscle inserts at the lesser tubercle of the humerus. It adducts and medially rotates the humerus.
ROTATOR CUFF TEAR.
A rotator cuff tear is a tear of one or more of the tendons of the four rotator muscles of the shoulders. A rotator cuff “injury” can include any type of irritation or overuse of those muscles or tendons and is among the most common conditions affecting the shoulder.
SYMPTOMS OF A ROTATOR CUFF TEAR
These include pain at rest and at night specially if lying over the affected shoulder, pain when lifting or lowering the arm or with specific movement, and weakness when lifting or rotating your arm.
TREATMENT OF ROTATOR CUFF TEAR.
There is a significant amount of research that shows surgery to be largely ineffective for many cases of rotator cuff tears. In large tears over 60% do not heal not even with surgery. Additionally many surgical patients do not recover full range of motion following surgery. For patients over 60 years of age the rate of failure to recover after surgery reaches 30%. Do not be intimidated when a surgeon tells you that delaying surgery increase the size of the tear. The fact is that 75% of the tears either get better, heal or remain the same.
Surgery is not the best option because when the rotator cuff tears on its own or with minimal trauma it is a sign that the tissue has become unhealthy caused by the structure of the tendon becoming week and degenerated because of the reduction in the natural number of functional stem cells in the tissue. For this reason surgically sawing together a tear frequently fails. It is like sawing tissue paper to tissue paper. This is the cause of the high rate of re-tears after surgery.
So, due to the above mentioned reasons something needs to be done to replace he lack of cells needed for healing and repair of the tissues. About 70 to 80% of patient with rotator cuff tear can take advantage of an innovative treatment pioneer by Dr. Christopher Centeno and his group in Denver Colorado. Precision guided Proliferative therapy injection and also treatment with plasma rich in platelets are a great alternative to surgery. Less risky, less traumatic and with excellent results. One to six treatments are usually required. In other cases Cell Therapy procedures may also be used.