Rotator Cuff Repair: from Diagnosis to Recovery

Rotator cuff injuries can be painful, but not life-threatening. Rotator cuff injuries can happen to anyone, from wear and tear over time, a fall, or repetitive stress, such as athletes who play tennis or swimming. You might first notice it when making small motions such as combing your hair, lifting your arm to reach something off a high shelf, or carrying something heavy. It may even keep you awake at night.

To better understand rotator cuff tears, it helps to learn more about the anatomy of the shoulder. The rotator cuff is a group of muscles and tendons linking the upper arm bone to the shoulder blades, keeping it in the shoulder socket. Because the shoulder relies on a healthy rotator cuff to maintain its strength and range of motion, a tear or injury can significantly impair its function and impact quality of life at the same time. Rotator cuff repair surgery is a procedure to repair injuries to one or more of the tendons back down to the bone(tendons connect the muscles to the bones).

The symptoms can vary due to the cause of the injury. The tendons may be inflamed, torn partially, or torn completely.

Symptoms of a rotator cuff injury include:

• Shoulder weakness and pain, even while resting
• Shoulder pain making specific motions
• Popping or crackling sensations when moving the affected arm
• Decreased range of motion in the shoulder

Diagnosing a Rotator Cuff Tear

Early diagnosis of a rotator cuff injury is important because delaying medical attention can cause a torn tendon to retract, making it more difficult, if not possible, to heal with the odds of successful healing and treatment lower. Your doctor will first take a medical history and perform a clinical exam in which you will be asked to do a series of motions to determine the cause of your shoulder pain. Certain imaging tests will be necessary to confirm a diagnosis, which may include X-rays, MRI scanning, or an ultrasound. All these tests provide different views of specific internal shoulder structures.

Do I Need Surgery for a Rotator Cuff Injury?

Surgery isn’t always the first-line treatment. Many partial (frayed) rotator cuff tears can be treated nonsurgically, but these tears may expand over time, particularly if you do repetitive movements with the affected arm. If the tear is small, the following treatments may prove beneficial: rest, immobilization, over-the-counter medications, physical therapy, and steroid injections.

Surgery is recommended for rotator cuff injuries if your tear has grown larger, pain increases, or if you have diminished range of motion or strength in the affected arm. Others require surgery after nonsurgical treatments have not effectively relieved their shoulder pain after 6+ months. By discussing your rotator cuff treatment options with an orthopedic surgeon, you can make an informed decision about whether rotator cuff repair surgery is right for you.

The Rotator Cuff Repair Procedure

During rotator cuff repair surgery, you will be under sedation. Rotator cuff surgery is usually done through a minimally invasive, arthroscope technique. This surgery uses a tiny surgical camera arthroscope will be inserted into a tiny incision in the shoulder so your surgeon can view the internal structures to reattach the tendon to your bone. The number of small incisions can vary, and it will be necessary to insert other small surgical instruments. Once the tendon is reattached, sutures close the wound, and a clean dressing will be applied to the area.

If you have a very large rotator cuff tear or multiple tendons are affected, you may require a traditional approach to fix the tendon, meaning a larger incision will be necessary to view the injury and repair the tear. Some patients who need multiple complex procedures performed simultaneously require this “open” approach.

Healing from Rotator Cuff Repair

During the healing process after rotator cuff surgery, you will need to rest, immobilize your affected shoulder and arm in a sling or wrap, and gradually start a physical rehabilitation program to restore your strength, range of motion, and function. Recovery may take several months, and it’s important to follow your doctor’s instructions for pain management and rehabilitation. To ensure you have the optimal treatment outcome, our orthopedic specialists will customize a treatment plan taking into account the type of surgery, your unique needs, and recovery goals.

To learn more or to book an appointment at Fox Valley Orthopedics, please call (630) 584-1400 today.