Rotator cuff tears are common among athletes, particularly those involved in sports that require repetitive shoulder motions, such as baseball, tennis, rowing, or weightlifting. However, with surgical intervention, athletes can get back to their normal activities.
Rotator Cuff Tears
The rotator cuff is a network of four muscles and their associated tendons that cover the humerus, or the upper arm bone, and attach to the shoulder blade. The rotator cuff helps to keep the shoulder in proper placement, and also aids in the range of motion of the shoulder.
There are two types of rotator cuff tears: partial tears and full-thickness tears. Partial tears occur when there is damage to the tissue, but the tendon is not completely severed. Full-thickness, or complete, tears occur when the tendon completely splits in two.
The rotator cuff can tear during an injury, such as falling onto your arm, or occur in conjunction with another injury, like a broken collarbone or dislocated shoulder. This is called an acute tear. This tuype of tear could occur during high-impact sports, although it can happen during non-athletic activities as well.
Degenerative tears occur over time; the tendon can wear away with repetitive shoulder motion. The tendon begins to fray, much like a rope, as time goes on, which can eventually result in a complete tear. Degenerative tears are common among athletes, particularly those who play baseball or tennis, although the rotator cuff can also wear down as we age.
Treatment
Conservative treatment methods, such as rest, activity modification, and physical therapy, may first be used to treat symptoms. Non-steroidal anti-inflammatory medications like ibuprofen and naproxen, or steroid injections may be used to help manage pain. Dr. Bascharon also encourages her patients to lead a healthy lifestyle, maintaining a healthy diet and exercising regularly, to help with the recovery process.
If conservative treatments do not help to restore function in your shoulder, or if your tear is very large or caused by an acute injury, surgical treatment is often recommended. There are a few options for surgical treatment, depending on the size of the tear and the quality of the tendon and bone in the shoulder. The surgery can often be done on an outpatient basis, depending on the severity of your condition.
As technology has advanced, many rotator cuff repairs can be performed arthroscopically. During an arthroscopic rotator cuff repair, a small camera called an arthroscope is inserted into the shoulder joint through a small incision. The camera displays images on a monitor in the operating room, allowing the surgeon to see inside the joint and perform the surgery without using a large incision. Because arthroscopic surgery is less invasive than open surgery, healing time is often quicker.
Outcome and Recovery
Each method for rotator cuff repair produces similar results. The ultimate goal of surgery is to reattach the tendon and relieve shoulder pain. Dr. Bascharon will determine which surgical method will produce the best results for you.
Following surgery, your arm will need to be in a sling for up to 4 – 6 weeks. Then, you will begin exercising your arm, first starting with passive movements, working up to more active exercise. Patients who are already healthy and in good shape otherwise have an increased chance for quicker recovery and successful results. It is also important to follow all instructions given to you both before and after surgery, as these guidelines are designed to help ensure that your surgery and recovery are successful.
Recovery time varies for each individual, but most regain full function and strength within 4 – 6 months of surgery.
If you have questions about rotator cuff procedures, please contact Dr. Bascharon.