Tears in the shoulder usually occur in the supraspinatus muscle, or rather the tendon (also known as the tendinea), shown below.
During daily activities, the rotator cuff muscles are constricted
between the upper arm bone and the bone called the acromion which can be seen above, as shown below.
This phenomenon is called constriction or ‘impingement' as referred to in medicine
Tears are usually in the shape of a triangle as seen below, but may also be in other shapes and sizes.
In the advanced stages of the constriction, rotator cuff tears occur. In addition, the tears of the shoulder, i.e. rotator cuff muscles, may also occur as a result of ongoing, repetitive, forceful, daily, overhead movements (such as household chores or knitting or heavy lifting) over a long period of time, or as a result of sudden trauma (such as sudden strain of the arm after a sudden brake on the bus).
The result is a TEAR.
MRI image of a tear
Small anchors (also known as screws by patients) used in tear repair.
The sizes of metaland absorbable anchors placed on the left and right of a coin of 1 Turkish Lira, respectively, can be seen below.
Shape of the tear
The appearance of the tear in surgery
Arthroscopic shoulder procedures are performed by inserting various surgical instruments through the small incisions called PORTALS in the front-back and lateral side of your shoulder, directly accessing the problematic areas of your shoulder joint and gaining vision with the help of a monitor.
Application of anchors (screws) during surgery (A) and stitched appearance of the tear (B)
MRI image of a tear following repair with anchors!
X-ray image of anchors after repair
Post-operative follow-up and care
The post-operative care of constrictions and cuff tears are the same.
General recommendations for care :
Surgical wounds (incisions) should be kept dry for 2-3 days after surgery.
Sutures can usually be removed on the 8th-10th day after surgery.
Rehabilitation should be initiatedimmediatelyafter surgery for constriction: Exercises begin in the first week after surgery and continue for approximately 6 weeks. When the patients have a full range of motion at the end of the 6th week, the strengthening exercises and the home-based exercise program begins.
While full recovery depends on the surgery, most patients experience a significant recovery at the end of the 3rd month and almost return to normal in about 6 months.
Recovery of the rotator cuffis usually slow and requires more therapy support compared to constriction surgery.
In order to achieve a full and rapid recovery after surgery:
Controlled and careful physiotherapy in the first 6-12 weeks for the tendon to attach to the bone and heal,
The primary goal for the first 3 months after surgery is to achieve a nearly full range of motion. Movements that are actively performed by the patient himself/herself (movements that the patient performs with his/her own power without assistance) are not allowed, especially during the first 6 weeks (1.5 months).
When the initial recovery is achieved after 6 weeks, the stretching program is initiated, followed by the strengthening program.
Sports activities are allowed after the 6th-7th month. Full recovery usually takes 1 year.