Rotator Cuff Repair

A rotator cuff tear is a common condition that causes discomfort and disability for many adults. A torn rotator cuff weakens the shoulder, which makes daily activities like getting dressed, a painful and challenging task. Every year, approximately 3 million people in the United States see their doctor for shoulder pain due to their rotator cuff.

Overview

The rotator cuff is responsible for keeping your arm in the shoulder socket. The rotator cuff has an intricate interior of four muscles that are connected to form a covering around the top of the humerus bone (upper arm bone). This helps lift and rotate your arm with a full range of motion.

With a rotator cuff tear, one or more of these tendons are torn, and it is no longer able to attach to the head of the humerus. In most cases of rotator cuff tears, torn tendons start by fraying, and as damage gradually increases, it can completely tear. However there are different types of tears:

• Partial Rotator Cuff Tear – Damages soft tissues, but does not sever the soft tissue.
• Full-Thickness Rotator Cuff Tear – A complete tear that splits the soft tissue in two. In most cases, tendons tear off of where it is attached to the head of the humerus.

Tears can be caused by injury, like lifting a heavy object, or degeneration. Degeneration refers to the wearing down of a tendon due to repetitive stress, lack of blood supply, or bone spurs, developing slowly over time.

Symptoms

A rotator cuff injury may include the following symptoms:

• Pain during rest or sleep, specifically when lying on the injured shoulder
• Pain when lowering or lifting your arm
• Shoulder weakness when lifting or rotating arm
• Crackling or tingling sensation when moving shoulder

Sudden tears usually cause intense, immediate pain, and you may experience a snap sensation. Tears that develop from overuse or wear will gradually cause pain and arm weakness. An evaluation with Dr. Hackett can help diagnose a rotator cuff tear, and he can determine which treatment would be best for the severity and your lifestyle.

Treatments

Chronic shoulder and arm pain are reasons to see Dr. Hackett in Vail, Colorado. Early treatment can help you avoid severe, painful symptoms and get you back to your daily activities faster. The objective of treatment is to restore function and alleviate painful symptoms the patient experiences. There are several treatment options for rotator cuff injuries, which Dr. Hackett will choose based on your lifestyle, age, and the type of tear.

Non-Surgical Treatments

For more than half of rotator cuff patients, non-surgical treatments can be effective in eliminating pain and improving the function of the shoulder. However, for younger patients, surgery is often the first choice of treatment since it can restore shoulder strength as well.

• Physical Therapy – A large part of non-surgical treatment is a physical therapy program that focuses on strengthening the rotator cuff tendons, regaining lost motion due to inflammation, and reducing compression of the bursa.
• Anti-inflammatory medications – Including ibuprofen and aspirin can help alleviate pain and reduce inflammation during physical therapy.
• Lifestyle Modification – Avoiding activities that cause shoulder pain may be an effective solution for the elderly or less active individuals.
• Steroid Injections – If the above methods are unable to alleviate your pain, Dr. Hackett may inject a local anesthetic and cortisone to reduce inflammation.

Surgical Treatments

Although many patients are satisfied with their non-surgical treatment of their rotator cuff tear, some patients are unable to regain motion and strength of the surrounding muscles. This often is seen in younger, more active patients and athletes. Other factors that may make you a candidate for rotator cuff surgery include symptoms lasting longer than six months, a large tear, significant weakness and loss of function, or a tear caused by an acute injury.Rotator cuff repairs can be performed with arthroscopic or open incisions. However, arthroscopic techniques, which utilize a small camera and is less invasive, may be limited to minor tears. With any surgical procedure, the objective is to get the tendon to heal, which generally involves securing the tendons back to the humerus. However, an evaluation with Dr. Hackett will help determine which surgical technique is most beneficial for you.

Rotator cuff repairs can be performed with arthroscopic or open incisions. However, arthroscopic techniques, which utilize a small camera and is less invasive, may be limited to minor tears. With any surgical procedure, the objective is to get the tendon to heal, which generally involves securing the tendons back to the humerus. However, an evaluation with Dr. Hackett will help determine which surgical technique is most beneficial for you.

Physical Therapy

Rehabilitation plays a significant role in a full recovery from a rotator cuff injury. A physical therapy program will be prescribed to help restore your shoulder strength and motion before returning to your daily activities. Generally, rehabilitation requires three steps including immobilization, passive exercise, and active exercise.

After surgery, you’ll most likely have to keep your arm in a sling for approximately six weeks to ensure proper healing. Then a therapist will help you with passive exercises when the Dr. Hackett says it is safe to move the arm and shoulder again. After approximately eight weeks, you will gradually be performing active exercises. Patients should expect rehabilitation to take several months for a complete and successful recovery. However, this will vary from patient to patient based on the severity of your injury and your natural healing process.