Physicians see more rotator cuff injuries than almost any other musculoskeletal injury. A patient with a rotator cuff injury will experience pain and weakness in the shoulder, but not swelling. Sometimes the patient does not have symptoms. Usually, though, the patient will have increased weakness and pain when active. This is especially true when raising the arm higher than shoulder level. Fortunately, there are quite a few treatments available for rotator cuff injury. The type of treatment that is suitable would depend upon the patient’s age and the type of injury experienced.
Rotator cuff injuries occur in two ways. You could either have rotator cuff tendonitis or a rotator cuff tear. It is important to realize that there are a few other conditions that can cause the type of pain one experiences with a rotator cuff injury. For an accurate diagnosis, you will need to see your physician. The first step your physician will take is a physical examination. Following the examination, your doctor may inject your injured shoulder with a local anesthetic. This process will help your doctor in determining exactly what kind of injury you have. If your doctor decides that you have a rotator cuff tear, he or she may send you for some imaging tests. Imaging tests will help pinpoint the location of the injury and confirm whether or not the injury is a tear.
Rotator cuff tendonitis is more common than rotator cuff tear, but the treatment is similar for both. Rest, ice, compression and elevation, also known as RICE therapy, is prescribed for both conditions. Your doctor may also tell you to take an over-the-counter pain medication like ibuprofen. You may also be referred to a physical therapist who will help you to understand how to modify your activities to avoid pain and may also give you instructions on exercises to help strengthen your shoulder. If these measures dont help, your doctor may give you a shot of a steroid/anesthetic mix. This injection will be made directly into the joint to help address your pain.
Of the patients who use this non-surgical intervention, about half report having a decrease of pain and an increase in range-of-motion within six weeks to three months. Aside from efficacy, there are a number of advantages to non-invasive therapy. Surgical risks such as permanent stiffness, anesthesia complications, and infection can be completely avoided. With non-invasive therapy, there is no down-time for recovery. On the other hand, use of non-invasive techniques may cause an increase in the size of the tear. While there is not a recovery period, there may be a time period when the patient is able to do less. Of course there is also the chance that the non-invasive technique simply will not work. In this case, your doctor may recommend surgery. Your doctor may also recommend surgery if your injury is so severe that he or she feels a non-invasive approach would not be effective.
Click here for more on rotator cuff tears .
There are three ways to treat a rotator cuff injury surgically:
1. Open repair surgery: With this option, the surgeon makes a full incision into the shoulder. This method gives the surgeon a great deal of freedom of movement; however, it is the largest incision option of the three available methods.
2. Mini-open repair surgery: This method is like open repair surgery, but it also utilizes arthroscopy. The advantages of this method are that it is an outpatient procedure that leaves a smaller scar.
All-arthroscopic surgery is the least invasive surgery. It is an outpatient procedure that leaves a very small scar.
After examining and diagnosing your injury, your doctor will be able to make a sound decision as to which method will work best for you.
Happily, rotator cuff surgery is a highly successful surgical procedure. Eighty to ninety-five percent of patients who have this type of surgery report successful results, improved range-of-motion and a significant decrease in pain in six months or less.
The success of your recovery is dependent on a number of factors. Among them are, your surgeons level of expertise, your fitness level, the severity of your injury, and your compliance with your doctors instructions.
Complications resulting from rotator cuff surgery are quite rare. The most commonly experienced complication is tendon re-tear. This is only experienced by about six percent of patients. Nerve injury may be experienced by one to two percent of patients. Infection may be a problem for one percent of patients. Fewer than one percent complain of stiffness. Less than one percent may have problems with deltoid muscle detachment.
Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Labral Surgery in Oregon and Tigard Labral Repair.
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