The shoulder joint is composed of numerous muscles and tendons that control stability and movement, including the rotator cuff. The rotator cuff is composed of four muscle-tendon units that work in unison to provide critical shoulder function. The tendons making up the rotator cuff include the subscapularis, supraspinatus, infraspinatus and teres minor. A subscapularis tendon tear is a rotator cuff injury that can occur in isolation from the other tendons. Orthopedic surgeon and shoulder specialist proudly serving the greater geo communities, Dr. Jonathan Ticker specializes in injuries of the rotator cuff, and especially tears of the subscapularis tendon.
A subscapularis tendon tear is often the result of trauma, such as a fall on an outstretched hand or if the arm experiences abduction away from the body during a fall. This particular rotator cuff injury is typically a partial thickness tear, meaning only a portion of the tendon is lifted away from its original attachment site on the humerus (upper arm bone). The partial tear may cause certain patients to experience biceps tendon (located next to the subscapularis tendon) pain as it slips out of its groove and begins to rub against other shoulder structures.
Symptoms of a Subscapularis Tendon Tear
The most common symptoms associated with a subscapularis tendon tear include pain, weakness and difficulty moving the arm behind the back. Patients may also experience joint tenderness, bruising and loss of function.
Diagnosis of a Subscapularis Tendon Tear
Dr. Ticker will perform a thorough medical review and physical examination to diagnose the rotator cuff injury. During the examination, he will assess the affected shoulder’s range of motion and ability to raise the arm with a variety of tests. An x-ray, ultrasound or MRI scan may then be performed to carefully examine the joint’s bones, ligaments and tendons. An MRI is most commonly utilized by Dr. Ticker since it best displays the location and severity of the subscapularis tendon tear.
Treatment of a Subscapularis Tendon Tear
Patients with low demand of the shoulder joint, such as elderly patients, may be prescribed non-operative measures such as rest, medications, modified activities and a detailed physical therapy and rehabilitation program.
The majority of patients suffering from a subscapularis tendon tear are prescribed an arthroscopic surgical procedure to repair the damage. The overall goal of surgical treatment of this rotator cuff injury is to re-establish the connection between the torn tendon and its original attachment site at the upper arm bone. If the biceps tendon is also affected, Dr. Ticker may perform a biceps tenodesis during the same procedure. During a biceps tenodesis, a release of the tendon from its attachment inside the shoulder joint takes place, and the tendon is reattached to the upper arm bone. Treatment of the biceps may also include a tenotomy, under certain curcumstances.
If you live in the greater geo area and have experienced a rotator cuff injury, such as a subscapularis tendon tear, please contact the orthopedic office of Dr. Jonathan Ticker.