Shoulder injuries are common, can occur at any age, and for various reasons. A fall, sports injury or aging can cause a rotator cuff tear. The pain may be so severe that the injured person is unable to participate in sports or perform basic life activities, like showering, or shopping.

What is the Rotator Cuff?

The rotator cuff is a group of muscles and their tendons that cover the head of the humerus (the upper arm bone). They work together to stabilize the shoulder, keep the shoulder in its socket and provide the ability to rotate and lift the arm.

Rotator Cuff Tears

A rotator cuff tear is a tear in one of the shoulder tendons.  It may be partial (still partially attached to bone) or complete (When the tendon is completely torn off the bone). Frequently a tear is accompanied by other shoulder injuries like a broken collarbone or dislocated shoulder.

Causes of a rotator cuff tear include:

• An acute tear from a fall, an accident, or a sports injury.
• Degenerative tears due to normal wear usually affects the dominant arm. The risk of a degenerative tear increases with age.
• Repetitive stress causes overuse tears. They are common in baseball, tennis, rowing and weight lifting. Certain jobs and routine chores can also cause these tears.

Risk factors

• Age
• Sports
• Construction jobs
• Family history- genetic component

Symptoms

• Initially the pain may be a dull ache that progressively worsens with use
• Often the pain is significant and interferes with sleep
• Pain may occur when lifting or lowering the affected arm
• A crunching sensation when the shoulder is moved in certain positions
• Weakness when lifting or rotating the arm

When to see a Doctor?

• When you have immediate, intense pain and loss of motion after injury
• When pain lasts more than a few weeks. Long- lasting pain is a sign that surgical repair is needed
• When pain and weakness interfere with daily activities

Diagnosis

During your exam your Grossmont orthopedic surgeon will listen to your symptoms, question the circumstances that caused your pain, and review your medical history. A physical exam will evaluate the joint including range of motion and strength testing.

X-rays will show bone spurs or other causes of shoulder pain. An MRI will show soft tissue damage, and reveal the tear, its location and size, and can also show the age of the tear, and the quality of the cuff muscles.

Nonsurgical management

About fifty percent of patients achieve pain relief and improved function with nonsurgical management.

• Rest, ice and PT
• Modified activity
• NSAIDS help with pain and swelling
• Physical Therapy will improve flexibility and range of motion.
• Steroid injections may be offered if rest, medication and therapy don’t relieve the pain.

Nonsurgical management is valuable because it avoids surgery, infection, permanent stiffness, anesthesia complications, and a lengthy recovery. However, it won’t improve strength, and may increase tear size.

What is Arthroscopic rotator cuff repair? 

Arthroscopic repair is outpatient, minimally invasive surgery to fix a torn rotator cuff. It is a very successful procedure to relieve pain and restore function.

Advantages of arthroscopic repair include less bleeding, less soft tissue trauma, earlier mobilization, and shorter recovery than with open surgery. However, this surgery requires expertise so you want experts and you will find them at Grossmont Orthopedics in La Mesa, CA.

Arthroscopic rotator cuff repair will be recommended when:

• Recent acute injury results in a large tear
• Continued pain that fails to resolve with nonsurgical management is a primary indication for surgery.
• When pain and weakness severely interfere with quality of life.
• Active patients seek to restore shoulder function

The goal of arthroscopic repair is to relieve pain and restore function.

The Procedure

Under general or regional anesthesia with twilight anesthesia, the surgeon will insert the arthroscope into the joint through several small incisions or portals. the arthroscope contains small camera that allows the surgeon to view the joint on a video screen and insert miniature surgical instruments to repair the tear, reattach the tendon to bone, restore anatomy, remove bone spurs and smooth the damaged tendon. If there are other shoulder injuries, they will be repaired at the same time.

Recovery

After surgery you will wear a sling to immobilize the shoulder. Recovery can take 4-6 months with physical therapy to help you restore motion and strength,

At Grossmont Orthopedics in La Mesa, CA our orthopedic surgeons are board certified and fellowship trained orthopedic experts will treat you with respect and compassion using advance, state-of-the-art procedures to help you get back to the life you love. Contact us to schedule an appointment to get the correct diagnosis and treatment.