Rotator Cuff Tear Treatment in Gurgaon: Causes, Symptoms & Expert Care

The shoulder is one of the most mobile joints in the human body, allowing us to reach, lift, throw, and embrace. But this incredible range of motion comes at a cost: stability. To keep the shoulder joint centered and functional, the body relies on a critical group of muscles and tendons known as the Rotator Cuff. When the rotator cuff is torn—whether from a sudden sports injury or years of silent wear and tear—the results can be debilitating. It starts as a dull ache when reaching for a seatbelt, progresses to an inability to comb your hair, and often ends in severe night pain that makes sleep impossible and rotator cuff tear treatment in Gurgaon can help you get relief .

A Rotator Cuff Tear is not just “a sore shoulder.” It is a structural failure of the tendons that power your arm. If left untreated, these tears can enlarge, leading to permanent muscle weakness and a severe form of arthritis known as Cuff Tear Arthropathy.

Dr. Ramkinkar Jha, top orthopaedic surgeon in Gurgaon offers a comprehensive approach to shoulder health. Using the latest in Arthroscopic (Keyhole) Surgery and evidence-based rehabilitation, we help patients restore their strength and return to a pain-free life.

Understanding the Anatomy of a Tear

To understand your injury, you must understand the architecture of the shoulder. The shoulder is a “ball-and-socket” joint. The head of the humerus (ball) fits into the glenoid (socket).

What is the Rotator Cuff?

It is not a single object, but a confluence of four distinct muscles that originate from the shoulder blade (scapula) and fuse into tendons that wrap around the head of the arm bone (humerus). These four muscles are often remembered by the acronym S.I.T.S.:

1. Supraspinatus (The Top Muscle): Responsible for lifting the arm away from the body (abduction). This is the most commonly torn tendon (approx. 90% of cases).
2. Infraspinatus (The Back Muscle): Responsible for rotating the arm outward (external rotation), like when you brush your hair.
3. Teres Minor (The Lower Back Muscle): Assists with external rotation and stabilization.
4. Subscapularis (The Front Muscle): Responsible for rotating the arm inward (internal rotation), like when you reach into your back pocket.

How a Tear Happens

A rotator cuff tear is essentially the detachment of these tendons from the bone.

• Hypovascular Zone: The supraspinatus tendon has a specific area near its insertion point that has a very poor blood supply. This “critical zone” is prone to degeneration because the body cannot easily repair minor damage there.
• The Tear Progression: It often starts as tendinosis (fraying of the rope). Over time, this fraying deepens into a partial tear. Eventually, the tendon snaps completely (full-thickness tear), leaving a hole in the cuff.

Causes of Rotator Cuff Tear: Acute Trauma vs. Chronic Degeneration

Rotator cuff tears are generally classified into two distinct categories based on how they occurred.

1. Chronic Degenerative Tears (Most Common)

These tears occur slowly over time and are naturally associated with aging.

• Age Factor: The prevalence of tears increases dramatically with age. Studies show that 28% of people over age 60 and 65% of people over age 70 have some degree of rotator cuff tearing.
• Bone Spurs (Impingement): Many patients develop a bone spur under the acromion (the roof of the shoulder). When you lift your arm, this spur rubs against the tendon—a condition called Shoulder Impingement. Over years, this “sawing” action cuts through the tendon.
• Repetitive Stress: Occupations or hobbies requiring repetitive overhead motion (painters, carpenters, tennis players, cricketers) accelerate wear and tear.

2. Acute Traumatic Tears

These occur in healthy tendons due to sudden force.

• Falls: Falling onto an outstretched arm to break a fall.
• Lifting: Jerking a heavy suitcase or gym weight with poor mechanics.
• Dislocation: In patients over 40, a dislocated shoulder almost always results in a torn rotator cuff.

Rotator Cuff Tear: Signs and Symptoms

The symptoms of a rotator cuff tear can be specific. While some degenerative tears are painless, most patients experience:

• Pain Arc: Pain is often felt on the outside of the shoulder/upper arm, specifically when lifting the arm between 60° and 120°.
• Night Pain: This is the hallmark symptom. The pain is a deep, toothache-like throb that prevents you from sleeping on the affected side.
• Weakness (Pseudoparalysis): You may feel like your arm is “dead” or heavy. You might struggle to lift a gallon of milk or hold your arm up to blow-dry your hair.
• Crepitus: A grinding, clicking, or popping sensation when moving the shoulder.
• Specific Motion Loss:
  • Supraspinatus tear: Trouble lifting the arm to the side.
  • Subscapularis tear: Trouble reaching behind your back (tucking in a shirt).

Rotator Cuff Tear: Diagnosis & Imaging 

Dr. Ramkinkar Jha utilizes a rigorous diagnostic protocol to ensure no aspect of the shoulder pathology is missed.

1. Clinical Examination

Dr. Jha performs specialized provocation tests to isolate the torn tendon:

• Empty Can Test (Jobe’s Test): Isolates the supraspinatus.
• Drop Arm Sign: If the doctor lifts your arm and you cannot control it as it lowers, it indicates a massive tear.
• Lift-Off / Belly Press Test: Checks for tears in the subscapularis (front of the shoulder).

2. Advanced Imaging

• X-Rays: While X-rays cannot show the tendon, they are vital for checking for bone spurs, arthritis, or a “high-riding humerus” (which indicates a massive, long-standing tear).
• MRI (Magnetic Resonance Imaging): This is the gold standard. An MRI allows Dr. Jha to see:
  • Tear Size: Small (<1cm), Medium (1-3cm), Large (3-5cm), or Massive (>5cm).
  • Retraction: How far the tendon has pulled back from the bone.
  • Muscle Quality (Fatty Infiltration): This is critical. If a tendon is torn for too long, the muscle turns to fat. Once this happens, the tear may become irreparable. This is why early diagnosis is key.

Rotator Cuff Tear: Treatment Options

Rotator Cuff Tear Treatment in Gurgaon is not one-size-fits-all. It depends on your physiologic age, the size of the tear, and your functional demands.

1. Non-Surgical Treatment: Conservative Management 

Appropriate for partial tears (<50% thickness) or elderly patients with low activity demands.

• Physiotherapy: Focuses on strengthening the remaining intact cuff muscles (Anterior Deltoid and Periscapular muscles) to compensate for the torn tendon.
• Activity Modification: Avoiding overhead lifting and movements that cause impingement.
• Steroid Injections: A precise injection of corticosteroid and local anesthetic into the subacromial space. This reduces inflammation and allows for pain-free physiotherapy. Note: Frequent injections are avoided as they can weaken the tendon tissue.

2. Surgical Treatment: Arthroscopic Rotator Cuff Repair

Surgery is recommended for:

• Acute traumatic tears (surgery should be done within weeks).
• Active patients with full-thickness tears.
• Tears causing significant weakness or failure of conservative treatment.

Step-by-Step Surgical Procedure: All-Arthroscopic Repair

Dr. Ramkinkar Jha performs this surgery using keyhole techniques, avoiding large incisions and muscle cutting.

• Step 1: Debridement & Acromioplasty: The surgeon removes inflamed bursa and shaves down the bone spur (acromioplasty) to create space for the tendon to heal.
• Step 2: Footprint Preparation: The bone where the tendon attaches (the footprint) is cleaned to stimulate fresh bleeding, which contains healing factors.
• Step 3: Anchor Placement: Bio-composite or PEEK anchors (which look like small screws) are inserted into the bone. These anchors have high-strength sutures attached to them.
• Step 4: Suturing: The sutures are passed through the torn tendon using specialized needles.
• Step 5: Knot Tying: The sutures are tied down, pulling the tendon firmly back against the bone to recreate the anatomy.

Advanced Technique: Double-Row Repair

For larger tears, Dr. Jha utilizes the Double-Row Suture Bridge technique.

• Standard Repair: Uses one row of anchors.
• Double-Row Repair: Uses two rows of anchors (medial and lateral). This compresses the tendon against the bone over a larger surface area.
• Benefit: This technique provides a water-tight seal, significantly higher structural strength, and a lower rate of re-tearing compared to single-row repairs.

3. Treatment for “Irreparable” Tears

In cases where the tear is massive and the muscle has atrophied, a standard repair may not work. Dr. Jha offers advanced salvage procedures for irreplaceable rotator cuff tears in Gurgaon:

• Superior Capsular Reconstruction (SCR): A graft (dermal patch) is used to replace the missing upper tendon, preventing the arm bone from hitting the shoulder roof.
• Reverse Shoulder Arthroplasty: For elderly patients with Cuff Tear Arthropathy, this specialized replacement changes the mechanics of the shoulder, allowing the deltoid muscle to lift the arm without needing the rotator cuff.

Rotator Cuff Tear: Recovery and Rehabilitation Timeline

Healing tendon-to-bone is a biological process that cannot be rushed. Post-surgery rehabilitation is broken into strict phases.

Why Choose Dr. Ramkinkar Jha for Rotator Cuff Tear Treatment?

The success of a rotator cuff repair depends 50% on the surgery and 50% on the rehabilitation. Dr. Ramkinkar Jha, top orthopaedic doctor in Gurgaon and Delhi NCR offers excellence in both.

• Specialized Training: Dr. Jha is an expert in shoulder arthroscopy, adept at handling complex tears, massive retractions, and revision surgeries.
• Joint Preservation Focus: Whenever possible, Dr. Jha utilizes techniques that preserve your natural anatomy, using tendon transfers or superior capsular reconstruction before considering joint replacement.
• Patient Education: We believe an informed patient heals faster. We explain your MRI, your surgical plan, and your rehab protocol in plain language.
• State-of-the-Art Technology: Artemis Hospital in Sector 51 and Clinic in Sector 71 are equipped for advanced diagnostics and post-op care.

Book an Appointment – International Patients

Rotator Cuff Treatment by Dr. Ramkinkar Jha

Are you traveling to India for advanced rotator cuff treatment? Dr. Ramkinkar Jha, leading Orthopaedic Surgeon in Gurgaon, offers world-class care for international patients seeking expert management of rotator cuff tears, shoulder pain, and sports injuries.

From your first inquiry to post-surgery recovery, our dedicated international patient team ensures a seamless and comfortable experience.

What Does an International Patient Expect?

• Pre-arrival online consultation with Dr. Ramkinkar Jha
• Assistance with medical visa documentation
• Help with travel planning & airport pickup coordination
• Comfortable hospital stay at reputed multispecialty center in Gurgaon
• Personalized rehabilitation & follow-up care
• Virtual post-treatment follow-up after you return home

Whether you require arthroscopic rotator cuff repair, revision surgery, or non-surgical management, we provide customized treatment plans using advanced techniques for faster recovery and optimal shoulder function.