Rathi's Ortho-Clinic

How to tackle Impingement Syndrome and Rotator Cuff Tear

Good Morning, I'm Dr. Pranav Rathi. I'm one of the Orthopedic Surgeon who specializes as a shoulder surgeon. I practice in Juhu, Andheri in Mumbai. Today I'm going to talk about ImpingementSyndrome and Rotator Cuff Tears. These ar e pathologies pertaining to the shoulder which commonly affects middle age to older individuals. For the benefit of the patients I have a shoulder model with me here. This is the shoulder joint. These are the muscles, the subscapilaries, the supraspenitors and when I turn it around the intraspenitous. These constitute the rotator cuff. This is the acromion which is the bony process.

Now we can easily make out that whenever we try to move these, these muscles run under this bony prominence. With age and degeneration sometimes there are extra bony prominences which grow on the under surface of the acromion, and these dig into the tendons. When this keeps happening this causes a lot of pain, especially when you're doing overhead activities like removing something from the top shelf. If this is neglected at that point then this continuous rubbing on the bony surface causes the tendons to become weak and it finally tears. That is called the Rotator Cuff Tear.

If you neglect a Rotator Cuff Tear which causes a significant weakness in the movement of your shoulder then your joint goes into arthritis and this arthritis is accelerated. What I mean by that is normal if a 70yr old gets arthritis, somebody with a Rotator Cuff Tear can get it 10yrs earlier at the age of 60 or 55 and you're really not that inactive and you really want to use the shoulder isn't it? So that is the reason why we should tackle these things the moment they're diagnosed. Now, the surgery to create more space under the acromion is called sub-acromion depression. It is done arthroscopically with just two stitches. At the same time if we find a Rotator Cuff Tear we can repair it using special suture anchors which go to the bones on one side and have threads on the other side to take these Rotator Cuff and bring it back to the bone. And that is how you can tackle it with a minimally invasive procedure.

Unfortunately, many patients come to me who have missed this bus and they've already had arthritis in their shoulders. Now, these procedures will not work to take away the pain of arthritis in which case you'll require shoulder replacement. Therefore, it is essential that you target these problems as early as possible to avoid a more invasive and a major surgical procedure like shoulder replacement.

Hope this information was helpful. For any furthur information or any queries you might have please contact me on Librate.