York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Medial Patellofemoral Ligament (MPFL) Reconstruction
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
10Shoulder-Treatment and Surgeries
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement


The rotator cuff is a structure composed of four muscle-tendon units. The four muscle-tendon units are the supraspinatus, infraspinatus, subscapularis, and teres minor. The most important function of the rotator cuff is to keep the proximal humerus (ball) well-positioned within the glenoid (socket). A secondary role of the rotator cuff is to provide one the ability to elevate, raise and rotate his/her arm and shoulder.

Rotator cuff injuries are relatively common. There are three distinct types of rotator cuff injuries:

  • Bursitis/Impingement
  • Tendinitis
  • Tear (partial-thickness or full-thickness)

Bursitis/impingement implies that the fat tissue sac above the rotator cuff is inflamed. Bursitis can occur with overuse of the shoulder or in patients who have irritated the rotator cuff tendons. Tendinitis implies that the tendon(s) of the rotator cuff are inflamed, but not torn. Tendinitis is common in patients with overuse injuries, such as in patients who play certain sports or in laborers. A tear of the rotator cuff may occur from a lifting injury, a fall on the shoulder, or with chronic wear and tear.


  • Sharp shoulder pain with overhead activity
  • Shoulder pain when sleeping
  • Weakness with shoulder use

 Diagnosis And Treatment

Dr. Welch considers each patient’s symptoms, as well as a detailed physical examination and x-rays to make the diagnosis of rotator cuff injury. Dr. Welch usually orders an MRI or ultrasound to confirm the diagnosis and evaluate the injury type and/or tear pattern. Most patients with tendinitis, bursitis, and partial thickness tears can be treated successfully without surgery. Treatment options include a physical therapy program, oral analgesics, as well as targeted injections (for example, steroid injections).

In those patients with full thickness rotator cuff tears or those with bursitis who fail non-surgical management, Dr. Welch may recommend surgery. Surgery is minimally invasive; Dr. Welch uses an arthroscope (surgical camera) and surgical instruments to remove the inflamed bursa, and if necessary, repair the torn rotator cuff.

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