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The Be Well Podcast - Rotator Cuff

Dr. Vellinga headshot photo

Listen in or read from the partial transcript as Ryan Vellinga, MD, Orthopedics and Sports Medicine provider at Skagit Regional Health, discusses the rotator cuff, signs and symptoms of a tear, and how Skagit Regional Health can partner with you in the event of an injury.

Disclaimer: This podcast is for informational purposes only and is not intended to be used as personalized medical advice.

Scott Webb (Host): Rotator cuff injuries and tears are common, especially as we get older. And I'm joined today by Dr. Ryan Vellinga. He's an Orthopedic Surgeon at Skagit Regional Health, Smokey Point, specializing in sports medicine, arthroscopy and reconstructive surgery. And he's here today to tell us about the rotator cuff, signs and symptoms of injuries and what he can do to help. This is Be Well, the podcast from Skagit Regional Health. I'm Scott Webb. Doctor, it's so great to have you on, and I want to talk to you today about rotator cuffs. A lot of us think we know what they are. We think we know what they do. Some of us may have even had rotator cuff injuries, but it's great to have an expert on today. So as we get rolling here, maybe you can explain to the audience what exactly the rotator cuff is, what it does, and just kind of take us through some of the basics.

Ryan Vellinga, MD: So, the rotator cuff is a term used to describe a group of muscles in the shoulder. Now there are four muscles that make up your rotator cuff of your shoulder. And the muscles are attached to tendons and those tendons attach the muscle to the bone. So, these tendons on the top of your arm bone in your shoulder form a cuff of tissue that goes around the top of the arm bone.

So, that's why they call it the rotator cuff because it forms the cuff, but then these muscles help rotate your arm around in space. And that's where it gets the name rotator cuff for the shoulder.

Scott Webb (Host): Yeah, and it seems my experience or my knowledge of rotator cuff injuries is often through sports often baseball pitchers in particular. So good to know, just kind of set the stage here, exactly what that is up there, what it does. And if one of us were to tear our rotator cuff, what symptoms would we likely experience?

Ryan Vellinga, MD: It can occur in two ways first of all. You can either have a traumatic tear. Like if you fell off of a ladder or something and landed on your shoulder, then you'd experience severe pain and inability to really raise your arm away from your body or overhead or up to shoulder height or something like that. But these tears can also be a slow degenerative tear that can develop over time from repetitive use. And either way though, when you start to get a tear, the pain will be in the shoulder kind of diffusely throughout the shoulder, or sometimes it can radiate from the shoulder down towards the elbow and the pain is typically worse when you're reaching your arm away from your body or reaching up to grab something from a shelf, sometimes reaching behind your back to tuck your shirt in or things like that. That's when people start to notice it. Pain with activities, and then it can progress to the point where they have pain even at rest and especially at night.

Scott Webb (Host): Yeah, so good to understand what we should be on the lookout for what we might be experiencing if we've had a tear. And I mentioned, you know, baseball players, and I'm sure they're not the only ones as you say, you could fall off a ladder and you could tear your rotator cuff, but who's generally most at risk for rotator cuff injuries?

Ryan Vellinga, MD: So, typically, the most common patients with rotator cuff tears are individuals in their fifties to sixties. And these are the slow degenerative types of tears that develop. And that's the most common patient that we see with these. For, what we call the acute traumatic tears, the ones that happened suddenly from a fall or lifting something really heavy and you feel a pop in your shoulder and all of a sudden you can't raise your arm, those traumatic type tears, still more commonly occur in middle-aged individuals. But they can occur in younger patients as well, just given the traumatic nature, if the trauma is severe enough, they can have that happen and another circumstance where you can see these traumatic tears as if someone dislocates their shoulder. Now a younger person when they're in their teens or twenties, if they dislocate their shoulder, typically they tear the labrum in their shoulder. But once we're getting close to the age of 40 and above, anyone who dislocates their shoulder, the most commonly injured thing is actually the rotator cuff, which gets torn.

Scott Webb (Host): Yeah. Interesting you mentioned labrum and both my kids play sports. And so they've been through one's already through high school and a number of friends, boys and girls who play sports, had that exact injury that you're describing. But as you say, as you get older, then it often becomes the rotator cuff.

And it sounds to me, especially as you say when we're not talking about the acute tears or the traumatic tears, where it's a sort of a slow burn, a slow build over time as they, the tear begins to get worse over time. Is this something that people generally can live with? Do you find the patients have lived with some pain, some discomfort for a long period of time before they actually end up in your office?

Ryan Vellinga, MD: Yes. I'd say usually at least a number of months if not several years. It's not uncommon for people to say their shoulder has hurt them off and on for years. And, you know, maybe they saw their primary care physician who gave him an injection or gave him some PT and it kind of got better for a while and then flared up again and got worse.

Yeah typically it's at least a matter of months. It's not something like you had no pain at all in your shoulder and then you didn't do anything, and you woke up with a horrible rotator cuff tear and pain all the time. That's not typically the case.

To listen to the podcast or read the full transcript, visit here.