Free rotation of your shoulder can be attributed to the various muscles and tendons that comprise the rotator cuff and connect your shoulder blade and upper arm. Rotator cuff injuries are often the result of periods of strenuous lifting, frequent use of your shoulder for overhead arm motions, and other causes, and can lead initially to tendinitis, subacromial bursitis, frequent shoulder weakness and pain, and long-term tissue damage before ultimately requiring surgery. Assessment of the injury is vital to surgical success, as the type of rotator cuff repair surgery you will undergo depends on a variety of factors, including the degree of your tear and the quality of your surrounding bone and tissue.
Some symptoms of rotator cuff injuries can be addressed through nonsurgical treatments, such as avoiding activity that triggers pain in the affected area, anti-inflammatory medications and steroid injections, physical rehabilitation programs, and rest. These steps can help reduce pain associated with rotator cuff injuries, however only surgery will restore shoulder strength for the damaged rotator cuff. For those who require surgery, open repair surgery is a method that involves making an open, multi-centimeter incision over the shoulder and dethatching the shoulder muscle in order to address a large or severe tear. This technique has the added advantage of allowing better sight and access to the injured tendon and facilitating the removal of any bone spurs or the completion of additional needed repair in the shoulder area. Through a mini-open repair procedure, another treatment option, a small incision is created to facilitate the passage of an arthroscopic camera for review and assessment of the injury area, including assisting with treating related injuries such as bone spurs. Viewing the damaged joint directly through the incision, the surgeon then repairs the rotator cuff.
Did You Know? Providers treated over four million Americans suffering from shoulder pain last year and rotator cuff tears are among the most common shoulder injuries. Rotator cuff injuries occur most frequently among the 40-70-year-old age group, as partially torn rotator cuffs are found in nearly one third of those over age 60.
Once the procedure is completed, rotator cuff surgery rehabilitation hinges upon the patient’s regular participation in physical therapy and avoidance of sedentary habits that could cause the joint to atrophy. Post-procedure hospital stays are usually not needed, as patients can generally begin recovering at home immediately after the surgery. Immediately after surgery, you will be prescribed anti-inflammatory medications for pain, and recovering patients will have their arms in a sling for four to six weeks, during which time a physical therapist, once approved by the surgeon, will help them engage in passive movement exercises for several weeks. As your rotator cuff heals, you will gradually increase the type and intensity of your exercises, which will allow you to increase strength and mobility over time.
Various factors can affect the success of rotator cuff surgery, including whether the injury occurred suddenly or over time, how soon the surgery occurs relative to the date of the tear, and the condition of the injured tendon immediately prior to surgery. While this surgery may repair many tears, those that are larger than two inches may require non-surgical treatments, such as grafting, and those that are surgically repaired may not heal completely.