Rotator Cuff Tears Come in Different Shapes & Sizes
By Dr. Matthew White, Orthopaedic Surgeon, Physicians’ Clinic of Iowa, Linn County LIVING WELL Magazine
In 2008, more than two million people saw their physician for the evaluation of a rotator cuff shoulder injury. The key is to know the symptoms and see your doctor so that appropriate treatment can begin.
How Your Shoulder Joint Works
Three main bones: 1) arm bone, 2) shoulder blade, and 3) collarbone work together to create a stable platform for the ball and socket of the shoulder joint. The rotator cuff compresses the top of the arm bone into the socket and drives much of the initial motion in the shoulder. Directly above the rotator cuff sits a fluid–like sac that cushions and lubricates the rotator cuff to allow it to glide freely with shoulder motion.
About Rotator Cuff Tears
The depth of the tear can be either partial or full thickness, and the nature of the injury can be either acute (having just happened) or chronic. Acute tears are commonly the result of a fall or caused by heavy lifting. Chronic tears represent a tendon that has been slowly damaged over time.
How to Spot a Tear
Individuals with a rotator cuff tear generally describe pain as a symptom. Pain can be on the outside of the shoulder radiating down the arm, or on the front of the shoulder. Often with acute tears, pain will be sharp and severe. Chronic tears often have a dull or throbbing pain. Pain while not using your shoulder is common as is pain at night. There may be some difficulty with overhead activities. These symptoms will persist over a time and rarely get better on their own.
When to See a Doctor
Anyone with shoulder pain should get a thorough examination. This involves an evaluation of the range of motion and strength or the shoulder, and a few tests to further pinpoint the problem. Imaging can be very helpful; plain x-rays are obtained first to check for arthritis of the joint, fractures of the bone, or any presence of bone spurs. If a rotator cuff tear is suspected, an MRI can be scheduled for closer examination. Physicians’ Clinic of Iowa offers imaging on-site and often at a lower cost than other facilities.
Rotator Cuff Treatment
Chronic tears or acute tears without weakness can often be treated with non-operative measures including: medications, physical therapy, activity modification, and Cortisone injections. In the event that several weeks of non-operative treatment does not work, then the next step is surgical repair.
Surgical Rotator Cuff Repair
Modern surgical techniques allow surgeons to perform rotator cuff repairs through a series of small incisions, no bigger than the width of your small finger. Surgery involves using a very small camera to look into the joint and remove inflammatory tissue. The rotator cuff tear is identified and then repaired using special anchors that hold the cuff in place while the body heals. Benefits of this arthroscopic surgical technique include better pain control, as well as less incisional healing required. Surgery can be done as an outpatient with no overnight hospital stay. Patients go home with an arm-sling and begin physical therapy within 24-48 hours following surgery. Most people can expect approximately three to four months of recovery following repair, though most return to office style work within a week or two. Risks, though uncommon, include infection, nerve injury, shoulder stiffness, and rotator cuff re-tear.
Although rotator cuff tears can be painful, Physicians’ Clinic of Iowa offers treatment options to reduce pain and increase function. If you’re experiencing shoulder pain, call 319-398-1545 and make an appointment today. We can discuss the options available and find the right solution for you.