Rotator Cuff Repair For Young Athletes: An Uncommon Operation With Excellent Results

By Dev Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Rotator cuff tears requiring surgery are uncommon in young athletes
  • Surgery typically leads to excellent function and very high return to sports at the same level or higher, although overhead athletes may need to change positions

The rotator cuff is a term used to describe a group of four tendons at the top of the shoulder responsible for movement and stability of the shoulder joint. We’ll typically see rotator cuff tears in older athletes. In young athletes the most common issue with the rotator cuff is an overuse tendonitis, and occasionally a partial tear. A complete detachment of the rotator cuff from the bone is very uncommon in young athletes, but it can happen. When a detachment happens it will require surgery for the young person to have the best chance of full function. Fortunately surgery can lead to excellent results.

At the James Andrews sports medicine center in Birmingham, Alabama, they have quite a bit of experience with rotator cuff tears. In this published study, they report on 2-year follow up of young athletes with rotator cuff tears who underwent surgical repair. Attesting to the rarity of this problem, in an 8 year period at this very high volume clinic they identified 32 athletes (28 boys and 4 girls) with an average age 16 years.

Each athlete played at least 1 sport, and 27 athletes had no shoulder issues prior to the start of their pain. Twenty-nine of the 32 tears resulted from a traumatic event.

The athletes all had surgery at the Andrews Center. Overall, 25 patients (93%) returned to the same level of play or higher. Among overhead athletes, 13 (93%) were able to return to the same level of play, but 8 (57%) had to change positions.

Surgery for rotator cuff tears can lead to excellent outcomes in young athletes, but what we find from these results is that overhead athletes could have difficulties returning to the same position after surgery.Logo

If you’re a young athlete with a complete detachment of the rotator cuff you’ll likely need surgery to best restore shoulder function for sports as well as other activities. These uncommon injuries would best be managed by a physician with substantial experience in treating shoulder injuries.