Rotator Cuff Injuries and Treatment
The rotator cuff is commonly affected by repetitive activities including work and sports. The rotator cuff is a group of 4 muscles surrounding the shoulder that provide motion and a stable joint. This muscle group allows for painless use of the shoulder above shoulder height. When the shoulder is injured or inflamed normal function is not possible.
The rotator cuff is commonly irritated by repetitive overhead activities or it can be injured acutely. The shoulder joint is made of the humerus or the arm bone and the glenoid or the socket. The rotator cuff is the muscle group that surrounds this joint. A bursa or fluid lined sac is located on top of the rotator cuff and protects the tendon from the acromion.
With repetitive use, the bursa becomes inflamed giving bursitis, the tendon becomes inflamed giving tendonitis, and then can eventually lead to a tear if not appropriately treated.
The portion or the tendon that inserts into the humerus has very poor blood supply and will not heal automatically. Evaluation includes a thorough history and physical exam by your AOC physician, x-rays, and a possible MRI.
The initial treatment for this condition is ice, NSAIDs, avoidance of provocative activity, a possible cortisone injection, and the assistance of physical therapy or home exercise program. The initial phase of treatment is aimed at decreasing the inflammation. Once the inflammation is under control, the patient can strengthen the muscle providing normal painless function. This treatment plan is successful in the majority of patients.
If the conservative management is not successful surgery may be indicated. The goal of surgery is to remove the inflamed bursa, remove any bone spurs , and repair the rotator cuff. The procedure is usually done arthroscopically as an outpatient. The recovery depends on the amount of work completed by your AOC physician. If the rotator cuff needs to be repaired this will lengthen the recovery process.
Usually after surgery, the patient is in a sling for 4-6 weeks. Physical therapy is individualized and will be used as the surgeon allows. Three to four months of recovery is typical.
The second type of rotator cuff injury is from an acute injury or accident. We now believe these acute injuries should be treated immediately. If the rotator cuff in young active patients is torn, we can promptly address this injury allowing for healing and return to normal function more quickly and more completely.
The physicians at Advanced Orthopedics Centers have treated many patients with conservative and arthroscopic repair the rotator cuff. Our approach provides excellent patient focused treatment aimed at returning the patient to their normal routine.
