Rupture of the rotator cuff
Rupture of the rotator cuff refers to damage to one or more shoulder tendons. When these tendons disintegrate from the head of the humerus, it is therefore called a rupture.
1) A LITTLE ANATOMY:
The shoulder joint is made up of 3 bones: the clavicle, the scapula (or scapula) and the humerus.
Its mobility is ensured by a musculotendinous and ligament complex. Among these muscles, we find the rotator cuff, which refers to all the periarticular tendons (and muscles) of the shoulder, namely the supraspinatus, infraspinatus, teres minor and subscapularis.
These tendons, arranged in continuity from front to back, cover the humeral head. They participate in the stability of the joint, playing the role of “active ligaments”, and allow optimal functioning of the shoulder.
Syndromes associated with a lesion of this rotator cuff represent the majority of consultations. If not treated properly, these pathologies can quickly become very debilitating and difficult to treat.
2) WHAT IS A “BREAK OF CUP”?
By definition, a rupture of the rotator cuff refers to the attack of one or more tendons of the shoulder. When these tendons disintegrate from the head of the humerus, it is therefore called a rupture.
This disintegration can be partial or total. In most cases, the affected tendon is the supraspinatus, and partially, but the lesion can then worsen and cause a complete rupture if it is not taken care of quickly.
This injury may lead to joint dysfunction and loss of function.
3) HOW AND WHEN DOES THIS HAPPEN?
The causes of this type of injury are multiple:
Natural wear caused by age remains the main cause of breakage. It is estimated that these affect 20% of those over 65, and up to 50% of those over 80.
Specific sports practices involving strong shoulder involvement can weaken the tendons
Untreated or poorly managed tendinopathies can lead to rupture
Violent trauma causing tendon traction (fall, etc.)
In addition, certain elements such as smoking or diabetes seem to cause a fragility of these structures, exposing them to greater risks of injury.
4) WHAT ARE THE SYMPTOMS?
In case of trauma, rotator cuff rupture leads to:
Severe localized pain in the shoulder
A loss of functionality (strength and mobility) of the shoulder
In the event of trophic rupture (progressive, rather linked to wear), the symptomatology is more discreet. The pain is less intense, and the lesion will be characterized more by a functional deficit.
If the pathology is not treated, it is interesting to observe an improvement in the symptoms after a few weeks, despite the pain still present.
5) IS IT SERIOUS?
The importance of the lesion can vary, ranging from the tearing of certain fibers to the complete rupture of the structure. It is still a serious injury that will require professional follow-up.
The diagnosis is then based on the clinical examination carried out by the practitioner, which generally makes it possible to determine the severity. This is confirmed by medical imaging (ultrasound, MRI).
It is interesting to note that from one case to another, the physical handicap as well as the pain can vary. For example, some victims manage to move their shoulder almost normally, while others will have to keep it immobile or suffer intense pain.
It is all of these examinations that will determine the severity as well as the therapeutic approach, whether surgical or not. The healing time also depends on the size of the lesion, its location and the speed of treatment.
6) IS SURGERY AN OPTION?
Surgical treatment can be offered to sports and/or active patients. It allows to reduce the immobilization time, a faster recovery and a reduced recurrence rate.
However, in most cases, conservative (and medical) treatment is nevertheless proposed in order to hope for results via a non-invasive solution.
The decision to operate or not will therefore be made following a discussion with the orthopedist in charge of your case.
7) HOW DOES THE REHABILITATION TAKE PLACE?
Conservative and post-operative treatment are similar on many points.
It will start with an immobilization of the shoulder to allow time for the tendon to heal.
Respecting the healing process, the work will then focus on:
Recovery of normal joint amplitudes
Gradual rehabilitation of the joint
Global and specific muscle strengthening (strength, neuromuscular control, stability, etc.)
Re-athleticization and rehabilitation in the sporting gesture
8) CAN I CONTINUE TRAINING?
In the event of a rotator cuff tendon rupture, it is generally essential to stop sports activity initially in order not to aggravate the situation.
Consulting a health professional then makes it possible to determine the procedure to follow in order to return to your sports practice as quickly as possible in complete safety.
9) WHAT CAN I DO TO SPEED UP THE PROCESS?
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!