Bummed Out About Your Cuff?
Rotator cuff injuries are the most common form of shoulder injury experienced by young and old alike. The rotator cuff is a group of 4 tendons and associated muscles that wrap around the shoulder joint. While a primary objective is protecting the joint, without the rotator cuff, shoulder stability, general mobility, and strength is near impossible. Rotator cuff injuries occur when high demands are placed on the shoulder, leading to wear and tear. Falls and accidents, particularly in sports, also lead to damage. With multiple tendons, muscles, and other components involved with the rotator cuff, there are different types of injuries. Surgery is an effective way to treat rotator cuff tears, but is not always the first or the best option.
Types of rotator cuff injuries
Rotator cuff injuries can range from mild to severe needing advanced treatment. Tendinitis is perhaps the most common, caused by inflammation of the tendons. This condition is typical in overuse injuries or sports. Bursitis, another rotator cuff condition, occurs when the lubricating bursa between bone and rotator cuff becomes inflamed. Another common case, called shoulder impingement, develops if a tendon is caught in the bone, leading to chronic pain. More severe situations involve rotator cuff tears, where part or all of a tendon is pinched or damaged. A doctor will diagnose the injury and provide an appropriate treatment plan. Knowing the right 3 questions to ask a doctor paves the way for effective treatment and long-term results.
1. Why is rotator cuff surgery being recommended in my case?
Surgery is often a last resort and is not taken lightly by surgeons. At the same time, the surgeon will recommend surgery if tests reveal the shoulder will not heal naturally. Some conditions like tendinitis, bursitis, or impingement respond well to non-surgical treatment. Using the rest, ice, compression, elevation (RICE) method helps. Physical therapy, pain medication, and steroid injections are other non-surgical options. If these fail, however, surgery can help. A clear sign of a severe partial or full-thickness rotator cuff tear can also benefit from surgery. Opting for surgery is especially useful for athletes who want to return to sport as soon as possible. The surgical team will assess the history of the injury, pros and cons, before making a decision.
2. What type of rotator cuff repair procedure will you perform?
The surgeon will have different methods available to address the severe underlying cause of the injury. At the core of the strategy is the option for open or arthroscopic surgery. With open surgery, the surgeon makes a large incision several inches along the shoulder. This option exposes the tendons and bone, allowing the surgeon to repair the shoulder. Arthroscopic surgery uses multiple small incisions of less than an inch and a special scope to access the joint. The scope projects the damaged shoulder on an external monitor, allowing the surgeon to use small tools to complete the repair. Rotator cuff repair can involve reattaching the tendon to the bone and removing bone spurs and tissue.
3. What are the realistic outcomes after surgery?
Most patients see significant improvement in mobility and a reduction in pain after recovery. The difference is especially noticeable if the patient attempted non-surgical treatment for extended periods without success. Statistics show patients enjoy significant relief for 10 years or more. Outcomes can also be determined by factors such as the procedure performed. Arthroscopic surgery, for instance, has fantastic advantages including reduced blood loss, smaller scars, and less postoperative pain. While the surgery has benefits, there are inherent risks with surgery and rotator cuff repair. There is also a low chance of a reoccurrence of the injury or a re-tear. The medical team explores all risks, finding ways to minimize issues during surgery.
The journey to a pain-free shoulder
Seeking medical advice for chronic shoulder pain is essential for treatment. The pain, stiffness, limited mobility, and eventual weakness are all signs of a potentially severe underlying concern. Let a doctor perform physical tests and x-rays to determine if surgery is best. Most cases benefit from non-surgical means and will heal naturally. For the many that do not, surgery brings long-term relief. Seek guidance from an experienced surgeon and make the right choice.
