One of the most frequent musculoskeletal injuries is the rotator cuff injury. Sometimes this type of injury is not associated with symptoms, but usually it is quite painful. A rotator cuff tear or rotator cuff tendonitis can cause you to experience pain and weakness in the shoulder when using your arms. It can be especially painful to lift the arm higher than shoulder level. Luckily, there are a number of ways to treat rotator cuff injuries - both surgical and non-surgical. The type of injury you have, your condition, and your age will be determining factors in deciding which type of treatment is right in your situation.
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.
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 surgery .
There are three ways to treat a rotator cuff injury surgically:
The first way is open repair surgery. When open repair surgery is chosen, the surgeon will make a full incision into the shoulder. This large incision has the potential of leaving a large scar; however, this method allows the surgeon to have a great deal of freedom of movement.
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.
The majority of patients who have rotator cuff surgery experience a decrease in pain and an increase in ROM (range of motion) within four to six months following surgery. In fact, eighty to ninety-five percent of people who have this surgery report satisfaction with the results.
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.
Some patients experience complications from surgery; however, these are rare. One to two percent may experience nerve injury. Approximately one percent may contract infection. Less than one percent may have detachment of the deltoid muscle. Less than one percent may experience stiffness. Tendon re-tear is experienced by approximately six percent of patients.
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.
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 surgery .
There are three ways to treat a rotator cuff injury surgically:
The first way is open repair surgery. When open repair surgery is chosen, the surgeon will make a full incision into the shoulder. This large incision has the potential of leaving a large scar; however, this method allows the surgeon to have a great deal of freedom of movement.
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.
The majority of patients who have rotator cuff surgery experience a decrease in pain and an increase in ROM (range of motion) within four to six months following surgery. In fact, eighty to ninety-five percent of people who have this surgery report satisfaction with the results.
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.
Some patients experience complications from surgery; however, these are rare. One to two percent may experience nerve injury. Approximately one percent may contract infection. Less than one percent may have detachment of the deltoid muscle. Less than one percent may experience stiffness. Tendon re-tear is experienced by approximately six percent of patients.
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, Portland ACL Surgery and Portland Athletic Injuries.
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