A rotator cuff tear is one of the most frequent causes of shoulder pain. It can also lead to other problems, such as arm weakness and difficulty moving the arm. Although not all rotator cuff tears require surgery, a rotator cuff repair procedure may be necessary if there is a complete tear or if nonsurgical treatments have proved unsuccessful.
What Is A Rotator Cuff Tear?
The rotator cuff is made up of a group of muscles and tendons that provide stability for the shoulder joint and help to hold it in place. The rotator cuff also allows you to lift, move, and reach up with your arms.
Rotator cuff tears happen when tendons pull away from the arm bone – the humerus. Although most rotator cuff tears occur gradually with overuse and general wear and tear, they can also happen suddenly, such as when falling on an outstretched arm.
Acute rotator cuff injuries usually cause immediate, intense shoulder pain (that may shoot down the arm), arm weakness, and sometimes a tearing, popping, or snapping sensation in the shoulder. Chronic rotator cuff injuries can get worse over time, with pain that may be more noticeable at night or when resting the arm. There will also be some degree of arm and shoulder weakness.
A rotator cuff tear falls into two categories:
- A partial (or incomplete) tear – where the tendon is still partially attached to the arm bone
- A complete (or full-thickness) tear – where the tendon separates completely from the bone
Treatment for Rotator Cuff Tears
The type of treatment necessary for a rotator cuff tear depends on a variety of factors, such as age, occupation, the severity of the tear, and other factors, but they do not always require surgery. While rotator cuff tears do not heal on their own without surgery, many patients can reduce pain and improve function with conservative treatments such as physical therapy, which helps strengthen muscles in the shoulder. Other non-surgical treatments can include:
- Nonsteroidal anti-inflammatory medications
- An arm sling
- Rest and activity modification
- Steroid injections
Surgical Treatment for Rotator Cuff Tears
For complete tears or if conservative treatments have provided little to no relief from symptoms, a rotator cuff repair procedure may be recommended. Surgery may also be recommended if your job, athletic interests, or other activities are likely to affect your shoulder. The goal of surgery is to help relieve shoulder pain, restore function and flexibility in the shoulder, and restore arm strength.
A majority of rotator cuff surgeries take place arthroscopically. Arthroscopic surgery involves inserting an arthroscope (small camera) and specialized surgical instruments through small incisions in the shoulder. Open repair surgery may be necessary if the rotator cuff cannot be repaired successfully using arthroscopy. The type of surgery you need will depend on the cause and the extent of the tear.
For a partial tear, surgery may only be required to trim fraying pieces of the tendon or remove bone spurs that may be causing a tendon to deteriorate. For more significant tears, surgery to reattach or repair the tendon may be required.
What Happens During a Rotator Cuff Repair Procedure?
Some rotator cuff repair procedures can be done on an outpatient basis. Depending on the specific type of procedure, you will be given either general, local, or regional anesthesia to ensure you do not feel anything during surgery.
Once your shoulder has been prepared for surgery, your surgeon will make an incision in the shoulder area. The arthroscope (if used) will then be inserted through the incision. Surgical tools will be inserted through other incisions in order to repair or replace injured tendons and muscles. A graft tendon from another part of the body may be used to repair the damage. If there are any bone spurs present, these will also be removed during surgery.
After the repair procedure is complete, the incisions will be closed with stitches or surgical staples and then covered with a sterile dressing or bandage. You may be given a sling to wear. You will be given pain relief medication to help keep you comfortable.
You will be given specific aftercare instructions to follow after you have been discharged, which will include guidance on what to do if you experience any problems or concerns, such as signs of infection. A follow-up office visit will be arranged with your surgeon to check your recovery and to remove the stitches or surgical staples. Your surgeon will let you know when you may resume certain types of activities.
Your healthcare provider will also arrange physical therapy or a rehabilitation program for you to promote healing and help you regain function, flexibility, and strength in your shoulder.
In a majority of cases, patients regain shoulder function and strength within 4-6 months after the procedure. However, it may take 12-18 months to make a full recovery.
Rotator Repair Near Me in Carmel, Indiana
If you are experiencing shoulder pain or restricted movement in the shoulder, visit Total Shoulder in Carmel, Indiana, for expert care. Board-certified and fellowship-trained orthopedic shoulder surgeon Dr. Jacobsen and his team diagnose and treat a wide range of shoulder conditions, including rotator cuff tears, utilizing the least invasive methods possible.