Rotator Cuff Injury

Shoulder injuries are fairly common, especially for people who tend to exercise a lot Some of the most common shoulder injuries are called "rotator cuff" injuries


The shoulder joint joins the upper body to the arm.
The bones included in the shoulder joint are the following:
Scapula, or shoulder blade bone
Humerus, or upper arm bone
 The shoulder bones are covered by tissue called cartilage.
 The smooth surfaces of the cartilage allow for smooth, painless movement in the shoulder joint
 Ligaments connect the bones and help to keep the shoulder in place Shoulder muscles that are attached
 This allows the to the shoulder blade are anchored in the head of the humerus shoulder to move in all directions
 The combination of the muscles and ligaments in the shoulder is called the "rotator cuff"
 The rotator cuff is located under part of the shoulder blade
 The "bursa" is a fluid-filled sac that is located between the shoulderjomt and the rotator cuff This prevents the rotator cuff from rubbing against the shoulder.


  • What is a rotator cuff injury?
  • Most rotator cuff injuries are an inflammation of the tendon called a tendonitis
  • The tendon gets overworked or sometimes gets pinched between the bones of the shoulder and becomes inflamed. This is termed “impingement syndrome”.
  • In addition, there is a bursa which lies between the rotator cuff and the bone of the scapula (acromion). The bursa is a fluid filled sac that reduces friction between the tendon and the bone. Sometimes the bursa becomes inflamed along with the tendon, a condition called “bursitis”.
  • Sometimes the tendonitis will progress to the point that the tendon becomes frayed or torn.
  • Tears of the rotator cuff can be
  •  Partial thickness or full thickness.
  •  Partial thickness tears only go part way through the tendon.
  •  Full thickness tears extend all the way through the tendon, and the tendon is detached from the bone.

Common Causes of Rotator Cuff Injury

Four major muscles (subscapularis, supraspinatus, infraspinatus and teres minor) and their tendons connect your upper arm bone (humerus) with your shoulder blade (scapula).A rotator cuff injury, which is fairly common, involves any type of irritation or damage to your rotator cuff muscles or tendons, including: Tendinitis. Bursitis, Strain or tear, Normal wear and tear, Poor posture, Falling, Lifting or pulling, Repetitive stress.

Diagnosis of Rotator Cuff Injury

Doctor determine the cause of your pain through physical examination, and diagnostic imaging tests.These may include: X-rays, A magnetic resonance imaging.

Nonsurgical Treatment

Immediately after an injury, the so-called R.I.C.E. treatment is recommended.
R.I.C.E. stands for: Rest, Ice, Compression, Elevation

In nonsurgical treatment Includes:


Progressive physiotherapy and rehabilitation

Use Assistive and support Devices

Surgical Option

Indications for Surgery
Unremitting pain (esp. at night)

  • Loss of ADL function
  • Significant loss of strength
  • Bony impingement with failed rehab
  • Moderate to massive tears w/active job, healthy and < 50
  • Isolated partial & full thickness tears with high probability of success without relief from rehab.


Surgery types

Advantage and disadvantage two type of surgery:




  • Less invasive
  • Faster recovery
  • No deltoid incision
  • Very less swelling/pain
  • Visualize the whole joint
  • Requires more technical skill


  • More invasive
  • Slower recovery
  • Deltoid taken down
  • More swelling/pain
  • Can not visualize the whole joint
  • Less technical skill required

The word arthroscopy comes from two Greek words,“arthro” (joint) and “skopein” (to look).

The surgery for rotator cuff injuries depends on the extent of the problem.

The arthroscope is a fiber optic instrument which is put into the joint through a small incision. A camera is attached to the arthroscope and the image is viewed on a TV monitor. The arthroscope allows a full evaluation the entire shoulder joint, including the ligaments, the rotator cuff, and the cartilage surface. Small instruments ranging from 3-5 millimeters in size are inserted through additional incisions so that joint structures for any damage, an injury can be diagnosed, and damaged tissue can be repaired or removed.

For cases involving bad tendonitis or partial thickness rotator cuff tears, the entire procedure is done with the arthroscope.

  • The under side of the acromion is shaved down (an acromioplasty) so it will not impinge (pinch) the rotator cuff.
  • If the rotator cuff is frayed, it is cleaned (debrided).

For cases involving full thickness tears of the rotator cuff, the tear is usually repaired completely through the arthroscope.

  • The bone is prepared for the tendon to be re-attached, and then rivets (suture an-chors) are placed in the bone which contain sutures
  • These sutures are then weaved through the tendon, and the tendon is sewn back to bone
  • In most cases, bioabsorbable anchors are used, which are anchors that dissolve in the body.
  • Occasionally, metal anchors are used. If so, the metal anchors do not need to be removed.









Upcoming Events
  • Coming up with a mega campaign "Lets Fight Arthritis" on the occasion of World Arthritis Day, at A4 Block, Gauri Shankar Mandir, Paschim Vihar, New Delhi. The campaign will be on 9th October 2016(Sunday). 

  • Health Awareness Campaign on 28th August at Gurudwara Singh Sabha E Block Karampura, Delhi.

  • Coming up with a mega campaign on Spine & Back Pain on 5th June 2016 at Gurudwara New Ranjeet Nagar (near Satyam Ciema), Patel nagar, Delhi in association with Sukhmani Charitable Trust, Delhi.

  • Coming up with an awareness campaign on Arthritis Management & Control on 22nd May 2016 at Guru Ram Dass Charitable Medical Centre - Gurudwara Sri Guru Singh Sabha, Moti Nagar, Delhi.  

  • Mega campaign on Arthritis Management on "Mother's Day" 8th May 2016 at West Patel Nagar, Delhi - 110008

  • Mega campaign on Arthritis Management in association with "Varishth Nagrik Kesari Club" - Punjab Kesari Delhi on 6th April 2016 (Wednesday)

  • Dr. Ashwani Maichand Participated in Shoulder Conclave 2016 at JWT Marriott, Pune

  • Dr. Ashwani Maichand was the Table instructor for young doctors at Cadaver Joint Replacement Training on 21st February 2016 at All India Institute of Medical Sciences (AIIMS)

  • Arthritis Awareness campaign on 28th february 2016 from 10 am to 1 pm at Minomax Knee & Shoulder Clinics (8/29, West Patel nagar, Delhi, India)

  • Participating as a speaker on "Dificult cases of Hip & Knee Replacement" in 2nd Masters Course in Arthroplasty at Meril Academy, VAPI, Gujarat from 4th to 6th February 2016






Click here for our Events List



Contact Us
Dr Ashwani Maichand
M.S., M.Ch. (Ortho)
Fellowship Joint Replacement
Specialist : Knee & Shoulder
Dr. Rahul Kakran
M.s., M.Ch (Ortho)
Specialist : Minimal Invasive Spine Surgery (MISS)
Dr. Rajni Koundal
Consultant Physiotherapy
For Appointment : 9999074745
( Mr. Sunny ) 
For Upcoming Events : 9999071715
( Mr. Sarabjeet Singh)
Address : 
MinOmaX Knee & Shoulder Clinics
8/29, West Patel Nagar,opp. D.A.V. Sr. Secondary School (near Metro Pillar no. 198, Delhi-110008)
Timings : Daily 5:00 PM to 7:00 PM  ( Except Sunday).
Please Take Prior Appointment to avoid inconvinience.