Rotator Cuff Tear Surgery

Shoulder injuries—whether among athletes or those who work at a physically demanding job—are common. The repetitive overuse of the shoulder can lead to injuries within the series of muscles and tendons that are responsible for holding the shoulder in place, which is known as the “rotator cuff.” The rotator cuff provides the range of motion such as lifting the arm up or reaching outward. Overuse, repetitive motion, or age-related deterioration can all contribute to rotator cuff injuries. 

If you have a rotator cuff tear, surgical repair is usually required. Surgical procedures such as arthroscopy or open surgery can restore the functionality and range of motion of the shoulder.

What is a rotator cuff tear?

The shoulder is a ball-and-joint socket consisting of three bones. The arm is kept in the socket by a group of four muscles that cover the upper arm bone, which is known as the “humerus.” The rotator cuff attaches the humerus to the shoulder blade and provides the range of motion that allows you to rotate and raise your arm. 

When one or more of the tendons in the rotator cuff tear, it can become partially or completely detached from the humerus. A rotator cuff tear often begins as a small fray. In this case, a patient will feel slight pain or irritation when performing certain motions but still be able to maintain mobility. If the injury is left untreated, it may then result in a full thickness tear, which involves detachment from the bone.

A full thickness tear may also be classified as complete or incomplete. In an incomplete tear, only part of the tendon is separated from the bone. In a complete tear, the whole tendon becomes separated. 

The causes of rotator cuff tears

Injury and age are the two most common reasons for a rotator cuff tear. Cases that involve falling, sports injuries, or over-lifting can cause a sudden tear. Normal age-related wear can cause degradation over time, and also result in a rotator cuff tear.  

 

A rotator cuff tear is most often diagnosed through the use of an X-ray or an MRI. An X-ray can help to determine if pain or discomfort you are feeling is being caused by osteoarthritis. And, an MRI scan is able to detect the tissue in your shoulder and determine the extent of the tear. 

When trying to determine the cause of a rotator cuff tear, you may also undergo ultrasound. Ultrasound allows you to move your arm while real-time data about your muscles and tendons is recorded.

Non-surgical treatment options

Non-surgical treatment options for a rotator cuff tear are primarily focused on pain management. If the tear is minor, your doctor may first recommend a combination of physical therapy and rest to see if the tendon can strengthen. Physical therapy cannot repair a rotator cuff tear, but this treatment may help strengthen the muscles and tendons so they do not tear further. Steroid injections may also help with pain management, but they will not repair the tear and are not used as a permanent solution.

Surgical treatment

Since a rotator cuff cannot heal on its own, surgical treatment is the main course of action to take for repair.  Physical therapy may help to reduce pain and maintain full mobility, but it will not repair the tear in the tendon. 

If you have a rotator cuff tear, you should seek treatment as soon as possible. This is  an important step to take to ensure the damage doesn’t worsen. Consistently using the shoulder when there is a partial tear can result in a full thickness tear over time. This means more intensive surgery and a much longer recovery time.

The type of rotator cuff repair surgery to be performed is based around the size of the tear and the quality of surrounding tissue and bone. Arthroscopic surgery is the most common type of procedure performed for rotator cuff repair. This operation allows surgeons to inspect and diagnose the problems around a joint and make the surgical repairs that are needed. 

Shoulder arthroscopy is a common procedure that uses thin tools when smaller incisions are necessary. This means that the arthroscopy operation will be less painful for you and that the recovery time will be faster. 

Rotator cuff tear repair surgery is performed on an outpatient basis, which means that you will be able to return home the same day. A regional anesthetic is used that blocks the nerves and reduces pain. Most arthroscopic surgery procedures take approximately two hours to complete. 

Risks of rotator cuff repair

As with any surgical procedure, there are certain risks that may occur during the operation. Undergoing rotator cuff repair surgery can result in:

• Bleeding
• Infection
• Damaged nerves
• Reduced range of motion

In extreme cases, it is possible that the full range of motion may not be restored. This usually depends on the severity of the tear, and it can be improved with physical therapy treatment and light-resistance exercises. 

Recovery from surgery

Recovery from a rotator cuff repair can take a few months before full use and mobility returns. In the days following the surgery, you should not lie flat or on your side. It is also best to sleep in an elevated position, such as in a recliner. 

If your job involves low physical activity, you should be able to return to work in about one-to-two weeks following rotator cuff surgery. A labor-intensive job, however, may require a few months before you’d be able to return, so it is important to plan ahead.  

During your recovery period, you will be able to perform simple actions such as eating or typing. Heavy or more intensive movements should only be performed as part of physical therapy exercises as directed by your physical therapist to prevent reinjuring the shoulder. Typically, you should be able to shower in about 72 hours after the procedure. In the event you had open surgery, you will need to check with your doctor to see if this is allowable.  

You should take any medications you are prescribed as directed by your doctor. Antibiotics or pain medication, for example, should be taken for the entire prescription and not only when you feel better. Your doctor will also advise you on the use of over-the-counter medications such as aspirin. 

After your surgery, you will need to undergo shoulder rehabilitation. The purpose of physical therapy is to restore the function and range of motion in the arm and shoulder. It is common to begin strengthening exercises anywhere from one-to-two weeks after the procedure. In order to minimize the recovery time, it is best to perform exercises as directed by your physical therapist.  

Schedule an appointment

If you believe that you may have a rotator cuff tear, call Monterey Spine & Joint to schedule a proper evaluation and treatment. Our team of dedicated specialists and surgeons will help guide you through the entire rotator cuff repair process. Call our office or schedule an appointment online today!