A rotator cuff tear is a common injury that occurs from either daily wear and tear of the shoulder or from a sudden trauma that occurs most often from a sports-related injury. The remedy for a rotator cuff tear is to rest the shoulder until it heals, although often surgery is required to repair the tendon or reattach it to the head of the humerus, which is the long bone of the upper arm.
The rotator cuff itself is a group of four muscles and tendons that allow for you to lift and rotate your arms. This group of muscles is complex, allowing for a wide range of motion for your arms, which is useful, of course, daily.
Doctors assign two designations for rotator cuff tears. One is a partial tear, which refers to damage to a tendon. The second type is a complete tear. This refers to a tendon that has been torn free of the humerus bone and requires reattachment.
A rotator cuff tear can be painful, or it can be experienced as weakness in the shoulder with milder discomfort. The general symptoms are:
- Difficulty raising an arm
- Loss of motion in the shoulder
- General weakness of the shoulder
- Mild to severe pain
- Pain that accompanies specific movement
- An odd popping sound in your shoulder during movement
Minor rotator cuff tears can be managed with applications of heat or ice to provide pain relief or improved comfort. Also, non-steroidal anti-inflammatory drugs, such as ibuprofen, are recommended. Muscle relaxing and pain medications can also be used during the healing process.
Fortunately, if surgery is required, there have been advancements in techniques and equipment over the years that allow for minimally invasive surgery to repair rotator cuff tendons. Not only does this allow for outpatient surgery in many cases, it means quicker recovery times. It also means lower costs.
Your doctor will recommend a specific surgery depending on several factors. These include the amount of damage to the tendon, the medical history of the patient, and the doctor’s experiences with the various procedures. Other circumstantial factors could also influence this decision, such as the overall health of the patient or time constraints.
Three Surgical Options
The three basic surgical options for rotator cuff repair are open shoulder repair, arthroscopic surgery, and mini-open surgery.
Open Shoulder Surgery
Most often performed in a hospital setting, open shoulder surgery includes a surgical incision that allows the surgeon to view the shoulder muscles and tendons directly. This surgery most often requires the surgeon to detach the deltoid shoulder muscle to get a view of the damaged tendon. As such, this is the more invasive of the surgical options.
While performing open shoulder surgery, the surgeon will take advantage of the opportunity to also remove any bone spurs that may have formed on the underside of the acromion. This procedure is called an acromioplasty.
This option is chosen when the damage to the tendon is significant, including injuries in which the tendon has become detached from the bone. It is also the option chosen if a tendon replacement is required.
For arthroscopic surgery, the incision is tiny, just large enough to allow the surgeon to use very thin surgical equipment to repair a damaged tendon. Most often, there are two points of entry. At one point, the surgeon inserts a tiny camera into the shoulder, which will be used to guide the surgical procedure, which the doctor views on a monitor. The second entry point allows for the surgical equipment to be inserted into the area.
This is usually done on an outpatient basis at a medical clinic or the doctor’s office.
This surgery includes a combination of open shoulder surgery and arthroscopic surgery. The incision is usually about 3-5 cm long. The advantage of mini-open surgery is that as much of the surgical work is done through arthroscopic equipment so that the deltoid muscle does not have to be detached. However, the incision does allow the doctor to directly view what he is doing for parts of the surgery.
Rehabilitation and Recovery
As with any surgery, there is a period of rest and recovery, which is followed by a rehabilitation period in which the patient begins to adapt to new limitations or to regain strength and flexibility on a gradual basis. During early recovery, pain medication may be prescribed, although any use of opioid pain medication must include a discussion with your doctor on the dangers of pain medication addiction.
See a doctor
Contact a doctor or visit the emergency room in your area quickly if you suspect a bone infection is occurring. With any of the symptoms above, have a doctor check you out to decide on the necessary course of action.
In Tempe, call FXRX Orthopaedics & Bracing at 480-449-3979 for an appointment.