[Music] uh hello everyone I'm Dr nain Kumar LV I am a senior consultant in Orthopedics and Sports injuries at manipal hospital Serj up Road rotator cuff tears or rotator cuff injuries uh you may have heard of this term or you may be hearing this for the first time uh what is rotator cuff so this is a group of muscles which are deep inside the shoulder in the sense deeper than the deltoid muscles which are the outer muscles and these muscles if they are not functioning properly then we can get shoulder pain shoulder difficulty in movements or not having enough strength in the shoulder these three things can happen this this rotator cuff can get injured sometimes because of a fall on the outstretched hand kind of injuries or more commonly as a part of the degenerative wear and tear commonly we see these rotator cuff injuries in people who are in their 50s or 60s or even '70s that's the age group where we see the rotator cuff tears when we talk about rotator cuff tear we often refer to one muzzle out of four but it can be more than one as well if you are looking at the shoulder now these are the outer musles which you all recognize these are deltoid pector and traps but deeper inside we do have smaller Muses which find you the shoulder movement these are the four small muss of the shoulder which find to the shoulder movet so out of them the one on the top which is called supraspinatus this is the muzzle which often gets strong but the tail can be partial or sometimes it can be complete tear as well so when we talk about rotator cuff tears not all of them are bad some of them may be just a tendonopathy where the muscle tendons are not functioning appro Ely and for those simple exercise based treatments May suffice plus physiotherapy maybe or if they have got a partial tear kind of thing which is refusing to heal with simple modalities then a plasma injection or a PRP injection is something which we often use to help healing process so in people with a complete ear we often see that where the muscle has been Tor and literally it has separated from the bone where it's supposed to be attached uh many times we see a gap in between as well unfortunately often we see people quite late uh sometimes even 6 months one year or 2 years down the line as well the reason why people come late for these injuries is because they still are able to do some of the activities because their deltoids are still working they have still got a basic amount of movement with which they can manage it's not like the leg where they can't walk so people often come late so when we talk about the rotated cuff te especially the complete a so the if it's a complete here the muzzle can't grow back so if you don't do anything about this what's going to happen that's the first question you should be asking so if you leave a rotat cuff tear without a treatment then the problem would be that the muszle will go on retracting backwards and the gap between will increase so the ball and the socket will lose its congruity because the ball of the shoulder will start moving upwards so because of that in congruity the joint will become arthritic so it may take 2 years in some it may take 5 years in some but eventually it will lead to arthritis of the shoulder joint which is called rotator cuff arthropathy if one reaches the point of cuff arthropathy uh where the pain will be there throughout the day and night then apart from replacement surgery for the shoulder where we take out all the bone and put an artificial joint apart from that I don't have any other magical tools in my uh quiver but if you identify this at the right time the rotator cuff even if it is a complete it can be cured by doing a keyhole surgery and arthoscopic surgery this is a simple procedure where post that surgery you'll be allowed to use your arm within 2 to 3 weeks initially you'll be in an arm pouch you will start physiotherapy early but for you to use your arm as a normal arm it may take about 2 to 2 and a half months but this is something which is required to keep your shoulder in a good condition for rest of your life hope this helps [Music]