Rotator cuff tears are common in all ages. There are degrees of tears from partial thickness tears to full thickness tears. what this means is that the rotator cuff or supraspinatus tendon is normally attached to the humerus or shoulder bone but has become separated. With sporting activities such as throwing, tennis, volleyball or heavy lifting this muscle/ tendon unit can be damaged or partially or fully torn. These tears can be due to the repetitive aspect of the sport or a singular event.
Partial or incomplete tears of the rotator cuff can be treated without surgery. Pain relieving medications such as non steroidal antiinflammatory medications (advil aleve aspirin) and physical therapy are initial treatments. Minimally invasive treatments such as cortisone shots can provide short term relief and allow physical therapy to be done with less pain. However, cortisone will not cure the problem, but will allow physical therapy to be successful. Newer treatments include PRP which stands for plasma rich platelets is a technique performed within our office where blood is drawn and platelets are extracted from a centrifuge and injected into the shoulder joint to assist in the healing process. Excellent clinical results have been obtained with the use of PRP in all types of rotator cuff injuries.
When the rotator cuff is completely torn (full thickness tear) physical therapy and PRP can be considered, but surgery sometimes is required.
If surgery is required, it is generally an out patient arthroscopic procedure. Arthroscopy is the use of small incisions with viewing cameras within the joints to allow for repair and removal of damaged tissue. In the case of rotator cuff repair small anchors and sutures are placed witin the bone and rotator cuff to allow for the repair to occur. Rotator cuff tears can be small, medium or large but all of them can be repaired arthroscopically if the tissue is not too damaged.
In this day surgery (outpatient surgery), an anesthesiologist will provide a light general anesthetic so that the surgery can be performed safely.
Some patients have been told that this type of surgery is extrememly painful. However, it is rare in my practice to see our patients experience this type of pain. I have employed newer surgical techniques throughout my many years of practice and have encouraged skilled anesthesiologists to utilize ultrasound guided needles to block pain fibers that help to prevent what was once considered a very painful procedure.
In the post operative period physical therapy will be required but this will not begin for approximately 2-3 weeks after surgery. At Murphy Sports Medicine we also utilize state of the art concepts such as CPM (continuous passive motion machines). This is a mechanical chair that will be delivered to your home to passively move your shoulder, thus preventing stiffness and also helping to limit pain. CPM helps to take the place of physical therapy in the initial post operative period. This is another reason that rotator cuff surgery is no longer as painful as has been reported.
Your recovery will be predicated on the normal tissue healing process. This will require an inflamitory response by the body to complete the healing of the tissue. The use of advil, aleve and aspirin will inhibit healing and therefore should be restricted.
Swelling also inhibits tissue healing and therefore cold therapy is utilized. This enhances an early positive tissue response, and less pain.
We also encourage the use of vitamin supplements such as vitamin D-3, which helps with the absorbtion of calcium and necesary proteins for healing. This holistic approach to the non surgical treatment and surgical treatmment of orthopedic injuries is empasized at MurphySportsMedicine.
Rotator cuff injuries can be treated both non opperatively and operatively. Surgery is no longer an extremely painful procedure. Post-op rehabilitation is expedited by newer surgical techniques, post opperative pain management, the use of CPM and cold theraphy. One can expect recovery in as short a period of time as 3 months and as long as 6 months. This will be dependent on the size of the rotator cuff tear.
Early detection of rotator cuff injuries leads to better results and a lower incidence of surgery. Therefore if you are experiencing shoulder pain, clicking, grinding, weakness, stiffness and instability and pain has been present for longer than 6 weeks, it is recommended that you seek out a sports medicine specialist in surgery who can establish the correct diagnosisand get you back in the game.
Our practice is centrally located in La Jolla California, specifically in the UTC area. We see patients by appointment only and can see patients on the same day if it is emergent. We look forward to your speedy recovery at MurphySportsMedicine.