Of musculoskeletal injuries, rotator cuff injuries are one of the most frequent. A rotator cuff injury is quite painful and can cause shoulder weakness; however, it does not cause swelling. Interestingly, patients often do not have symptoms. Most of the time; however, the patient will experience pain and weakness during activities involving the arms. Raising the arm above shoulder level can prove particularly painful. On the bright side, there are quite a few ways to treat rotator cuff injuries. Your age and the type of injury you have will help determine which option will work best for you.
In addition to the two types of rotator cuff injuries already mentioned - tear or tendonitis - you should be aware that there are other conditions that may exhibit similar symptoms. Be sure to see your doctor to get the right diagnosis. He or she will give you a physical examination and will probably inject your shoulder with a local anesthetic. These procedures help your doctor to determine exactly what is wrong with your shoulder. If your doctor believes that you have a rotator cuff tear, the next step may be imaging tests to confirm the diagnosis and find the exact location of the tear.
It is far more common for the diagnosis to be rotator cuff tendonitis; however, the treatment for tears is very similar to the treatment for tendonitis. Both can be treated conservatively with what is known as RICE therapy. That is: rest, ice, compression, and elevation. You may also want to use an over-the-counter pain medication like ibuprofen. Additionally, your doctor may give you a referral to a physical therapist to learn how to modify your movements and to get a list of exercises that may be beneficial to you. If your tendonitis pain persists, your doctor may give you injections of a steroid/anesthetic mixture. These would be administered to the joint to relieve pain.
This sort of non-surgical intervention usually has a 50-50 chance of being effective. If it is to work, you will probably see results in 6 - 12 weeks. Using non-invasive techniques of this sort can be good in a number of ways. When you do not have surgery, you also do not have recovery time. Furthermore, you do not experience any of the risks commonly associated with surgery such as complications caused by anesthesia, permanent stiffening of the joint, or infection. One thing to realize, however, is that this approach can cause the original tear to increase in size. Additionally, even though there is not a set recovery time, you will be operating at less than your usual ability until you have completely recovered. Aside from these considerations is the fact that non-invasive techniques may not be effective. You may end up having surgery after all. If your injury is quite severe, your doctor may bypass the non-invasive option and recommend surgery right from the start.
Click here for more on rotator cuff tears .
When rotator cuff injury is treated with surgery, there are generally three options.
The method that allows the surgeon to operate most freely is called open repair surgery. This method utilizes a full incision in the shoulder. This option can leave a rather large scar.
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.
3. All arthroscopic surgery: This option is an outpatient procedure, and it uses the smallest incision.
The doctor will determine which procedure will work best based on the specific injury.
After rotator cuff surgery, most patients have decreased pain and an increase in range-of-motion. Recovery is usually complete within 4 to 6 months. Results are usually quite satisfactory, with 80 - 95% of patients reporting good results.
The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the 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.
In addition to the two types of rotator cuff injuries already mentioned - tear or tendonitis - you should be aware that there are other conditions that may exhibit similar symptoms. Be sure to see your doctor to get the right diagnosis. He or she will give you a physical examination and will probably inject your shoulder with a local anesthetic. These procedures help your doctor to determine exactly what is wrong with your shoulder. If your doctor believes that you have a rotator cuff tear, the next step may be imaging tests to confirm the diagnosis and find the exact location of the tear.
It is far more common for the diagnosis to be rotator cuff tendonitis; however, the treatment for tears is very similar to the treatment for tendonitis. Both can be treated conservatively with what is known as RICE therapy. That is: rest, ice, compression, and elevation. You may also want to use an over-the-counter pain medication like ibuprofen. Additionally, your doctor may give you a referral to a physical therapist to learn how to modify your movements and to get a list of exercises that may be beneficial to you. If your tendonitis pain persists, your doctor may give you injections of a steroid/anesthetic mixture. These would be administered to the joint to relieve pain.
This sort of non-surgical intervention usually has a 50-50 chance of being effective. If it is to work, you will probably see results in 6 - 12 weeks. Using non-invasive techniques of this sort can be good in a number of ways. When you do not have surgery, you also do not have recovery time. Furthermore, you do not experience any of the risks commonly associated with surgery such as complications caused by anesthesia, permanent stiffening of the joint, or infection. One thing to realize, however, is that this approach can cause the original tear to increase in size. Additionally, even though there is not a set recovery time, you will be operating at less than your usual ability until you have completely recovered. Aside from these considerations is the fact that non-invasive techniques may not be effective. You may end up having surgery after all. If your injury is quite severe, your doctor may bypass the non-invasive option and recommend surgery right from the start.
Click here for more on rotator cuff tears .
When rotator cuff injury is treated with surgery, there are generally three options.
The method that allows the surgeon to operate most freely is called open repair surgery. This method utilizes a full incision in the shoulder. This option can leave a rather large scar.
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.
3. All arthroscopic surgery: This option is an outpatient procedure, and it uses the smallest incision.
The doctor will determine which procedure will work best based on the specific injury.
After rotator cuff surgery, most patients have decreased pain and an increase in range-of-motion. Recovery is usually complete within 4 to 6 months. Results are usually quite satisfactory, with 80 - 95% of patients reporting good results.
The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the 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.
About the Author:
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, ACL Reconstruction in Portland and Sports Injuries in Portland.
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