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Rotator Cuff Surgery: How to know when you need surgery for your shoulder pain
Considering rotator cuff surgery to heal your aching shoulder? The shoulder specialists at Tennessee Orthopaedic Clinics see patients with rotator cuff injuries on an almost everyday basis. Not every patient requires surgery, but if your pain has come on suddenly or lasted quite a while, surgery may be right option for you. Read on to discover more about rotator cuff injuries, what causes them, and what we can do to help you regain range of motion and reduce pain in your shoulder.
What is a rotator cuff?
The rotator cuff is the set of muscles and tendons in the shoulder joint that keep the rounded head of the upper arm bone in place in the shoulder socket. These muscles and tendons help you rotate and lift your arm. Every time you swim, brush your hair, or reach something on a high shelf, you’re using your rotator cuff.
Causes of rotator cuff injuries
Rotator cuff injuries are commonly seen in our office and can range from minor to severe. The most common causes of rotator cuff injuries include:
- Overuse that eventually leads to a tear
- Sports injuries
- People with jobs that require repetitive overhead movements, like painters and carpenters
- Falls and accidents
Not all rotator cuff injuries require surgery
Many rotator cuff tears can be treated without surgery. Ice, rest, and OTC pain relievers may be all you need to recover from a minor rotator cuff injury. Corticosteroid injections in the joint as well as physical therapy can also help reduce pain and restore range of movement in the affected shoulder.
If these approaches do not provide the right level of relief, rotor cuff surgery may be necessary.
When do I have to have rotator cuff surgery?
Surgery may be a good option for your rotator cuff repair if your pain has continued for 6-12 months without relief, the tear in your rotator cuff is more than 3 cm wide, you are experiencing significant pain or loss of function in the affected shoulder, or your tear is caused by an acute injury and not long-term wear and tear.
How will my doctor know if I need rotator cuff surgery?
At your appointment, your doctor will examine your arm and assess the strength and movement of your shoulder. He or she will move your arm into different positions and press on parts of your shoulder to check for tenderness and other abnormalities. You may also be required to undergo certain tests to determine if you need rotator cuff repair surgery, such as:
- X-rays – An x-ray won’t show a rotator cuff tear because it occurs in soft tissue. But it can help rule out other sources of shoulder pain such as bone spurs or arthritis.
- Ultrasound – An ultrasound allows your doctor to visualize the soft tissues in your shoulder, such as the muscles and tendons that make up your rotator cuff.
- MRI – An MRI uses strong magnets to produce an incredibly detailed picture of the structures inside your shoulder. Having an MRI can help your doctor rule out other conditions that present similarly to a torn rotator cuff, such as bursitis and tendonitis.
Types of rotator cuff repair surgery
Medical advancements have led to the development of several types of rotator cuff surgeries, many of which are outpatient. Your surgeon will opt for one or more of the following rotator cuff repair surgeries depending on the exact nature of your injury.
Tendon repair surgery – Your surgeon will reattach your damaged tendon to the bone. There are two types of tendon repair surgery – arthroscopic and open. In arthroscopic tendon repair surgery, a tiny camera (arthroscope) is inserted into your shoulder via a small incision. This camera helps your surgeon use very small instruments to repair your damaged tendon. Sometimes an open tendon repair surgery is a better option, in which the surgeon operates through a larger incision. Open tendon repair surgery is recommended when the tear is large or especially complex.
Tendon transfer surgery – If the affected tendon in your rotator cuff is too damaged, your surgeon may opt to replace it with another nearby, healthy tendon. Tendon transfer surgery is typically an “open” surgery with a large incision.
Shoulder replacement surgery – Severe rotator cuff injuries may require shoulder replacement surgery in which an artificial joint replaces your natural shoulder joint.
How long until I can lift my arm again after rotator cuff surgery?
After your surgery, your arm will be kept in a sling for the first six to eight weeks. You can perform movements where your arm is not raised, such as eating and cooking, as soon as you feel able after surgery, which is likely to be right away. Raising the arm above waist level before the six- or eight-week mark could re-injure your healing rotator cuff.
Physical therapy after rotator cuff surgery
It’s important to keep your shoulder moving after rotator cuff surgery to prevent stiffness. Your physical therapist will likely have you doing pendulum exercises and passive range of motion exercises at home, in which the arm is moving but the muscles and tendons in the shoulder are not activated. These movements may be uncomfortable at first. Pain medication taken before therapy and heat applied after can help alleviate any discomfort.
Rotator cuff injury keeping you up at night?
Many patients with rotator cuff injuries say that they can’t sleep because of the pain. The shoulder specialists at Tennessee Orthopaedic Clinics can help you get the good night’s sleep you deserve by treating your rotator cuff injury. Call us today to schedule your appointment with one of our shoulder specialists.