Your shoulders play a crucial role in your daily activities, enabling you to lift, reach, and rotate your arms. However, due to their constant use and repetitive motions, they are susceptible to injuries and overuse issues.
The rotator cuff, a group of muscles and tendons in the shoulder, provides stability and facilitates movement. When these muscles and tendons become injured or damaged, it can result in pain, weakness, and limited mobility in the shoulder joint. Early diagnosis and appropriate management are essential for optimal outcomes and restoring function in the shoulder. Many rotator cuff conditions can be treated with minimally invasive arthroscopic procedures, which repair or alleviate discomfort in the shoulder joint.
What Are Rotator Cuff Injuries?
Rotator cuff injuries refer to damage or irritation to the tendons and muscles surrounding the shoulder joint, collectively known as the rotator cuff. These injuries often come in different types and severities, but they typically encompass tears, tendonitis, and strains:
Rotator Cuff Tears
Rotator cuff tears can range from small partial tears to complete tears, which may result from sudden trauma or develop gradually over time due to chronic degenerative changes in the tendon tissue. Depending on the size and location of the tear, symptoms may include pain, weakness, and limited range of motion in the shoulder joint.
Rotator Cuff Tendonitis
Rotator cuff tendonitis develops gradually over time due to repetitive overhead movements or activities that place stress on the shoulder. This leads to inflammation and pain in the affected tendons. If left untreated, it can progress to more severe symptoms and functional limitations in the shoulder joint, highlighting the importance of early recognition and appropriate management.
Rotator Cuff Impingement
Impingement occurs when the tendons in the rotator cuff rub against the bones in the shoulder joint. If not addressed, this rubbing can cause irritation, inflammation, and eventually damage the tendons. Rotator cuff impingement is often associated with repetitive overhead motions, such as throwing or lifting weights.
Rotator Cuff Strains
Rotator cuff strains are mild injuries to the muscles or tendons of the rotator cuff. They usually happen when the shoulder experiences sudden or excessive force or is repeatedly strained. These strains can result in pain, weakness, and swelling in the affected area, making it difficult to perform certain movements or activities involving the shoulder joint.
Rotator Cuff Calcific Tendonitis
Rotator cuff calcific tendonitis is characterized by the formation of calcium deposits within the rotator cuff tendons. These deposits can vary in size and may cause discomfort, especially with certain shoulder movements or positions. Over time, they can lead to pain, inflammation, and potential weakening of the tendon structure, impacting shoulder function and mobility.
Signs That You May Have a Rotator Cuff Injury
If you experience any of the following symptoms, you may have a rotator cuff injury:
- Shoulder pain, especially when lifting or reaching overhead.
- Weakness or loss of strength in the shoulder.
- Difficulty or pain when rotating the arm or lifting objects.
- Pain that radiates from the shoulder down the arm.
- Difficulty sleeping on the affected side due to discomfort or pain.
If you suspect you have a rotator cuff injury, it’s crucial to seek evaluation and treatment from Dr. Howard promptly.
Diagnosing A Rotator Cuff Injury
To diagnose a rotator cuff problem, Dr. Howard begins with an in-person examination and takes X-rays to rule out other issues like arthritis or bone spurs. He then reviews the X-rays, conducts a physical exam, and prescribes treatment. This may include anti-inflammatory medications and physical therapy, either in-person or through a home exercise program. If you are an appropriate candidate, Dr. Howard will also offer a cortisone injection into the shoulder to relieve pain. Progress is monitored over 4-6 weeks to assess improvement and evaluate whether the pain diminishes with these non-surgical treatments.
If your pain persists, an MRI may be recommended. Our staff will assist you in scheduling an MRI at a local imaging center.
Rotator Cuff Arthroscopy Preparation
When it comes to surgery preparation, you will be asked to avoid eating or drinking 12 to 24 hours before surgery. You will also be asked to disclose all the over-the-counter and prescription medications you take, as certain drugs increase the risk of complications like bleeding. Sometimes, you may be required to refrain from certain medications as long as one week before your procedure.
The Procedure
Arthroscopic shoulder surgery is a minimally invasive technique used to repair the rotator cuff tendon without major muscle or tendon cutting. Dr. Howard utilizes advanced methods, making small incisions and using specialized tools to access and repair the tendon with suture anchors. The surgery lasts from 45 minutes to 2 hours, depending on tear size, and is outpatient-based and conducted at ambulatory surgery centers for efficiency and cost-effectiveness.
Risks of Rotator Cuff Surgery
Major complications are rare when performed by an experienced orthopedic surgeon such as Dr. Howard. Like any other surgical procedure, arthroscopic surgery carries risks such as bleeding, infection, chronic post-operative pain, shoulder stiffness, or injury to neighboring structures, but these occurrences are uncommon.
Recovery
After surgery, immediate rehabilitation begins, with some anesthetic medications lasting up to 24 hours in your system. It is advisable to have a friend or family member stay with you for the first 24 hours at home. Dr. Howard typically recommends starting physical therapy within the first week after surgery. You’ll need to schedule the appointment, but the physical therapist can provide guidance and answer questions during the initial weeks, which are often the most challenging but improve gradually.
During your two-week office visit, sutures (stitches) will be removed, and X-rays will be taken for a general checkup. If you haven’t started physical therapy by this point, you’ll receive a prescription and be encouraged to begin. Assuming no complications, the next appointment with Dr. Howard will be in one month. Rehabilitation may extend over several months, with optimal shoulder function usually achieved within 3-6 months. Some patients may continue to see improvement for up to 12 months post-surgery. Follow-up appointments with Dr. Howard at 3 and 6 months after surgery are standard to ensure a complete recovery.
Preventing Rotator Cuff Injuries
Preventing rotator cuff injuries is crucial for maintaining shoulder health and function. Incorporating these preventive measures into your daily routine can help protect your rotator cuff and reduce the risk of developing painful and debilitating shoulder injuries.
- Maintain Good Posture – Proper posture helps distribute the workload evenly across the shoulder joints, reducing strain on the rotator cuff muscles and tendons.
- Strengthen the Rotator Cuff Muscles – Performing regular strengthening exercises targeting the rotator cuff muscles can help improve shoulder stability and resilience to injury.
- Warm Up Before Physical Activity – Engage in a proper warm-up routine before engaging in repetitive or overhead arm movements, such as sports or weightlifting.
- Use Proper Lifting Techniques – When lifting heavy objects, use your legs instead of your arms to reduce strain on the shoulders.
- Avoid Repetitive Overhead Activities – Minimize activities that require repetitive overhead arm movements. These put excessive strain on the tendons over time.
- Take Breaks During Repetitive Tasks – If you engage in repetitive tasks, like painting or gardening, take frequent breaks to rest your shoulders and prevent overuse injuries.
- Listen to Your Body – Pay attention to any signs of shoulder discomfort or fatigue during activities and take appropriate breaks or modify your movements to prevent injury.
Preventing Rotator Cuff Injuries
Preventing rotator cuff injuries is crucial for maintaining shoulder health and function. Incorporating these preventive measures into your daily routine can help protect your rotator cuff and reduce the risk of developing painful and debilitating shoulder injuries.
- Maintain Good Posture – Proper posture helps distribute the workload evenly across the shoulder joints, reducing strain on the rotator cuff muscles and tendons.
- Strengthen the Rotator Cuff Muscles – Performing regular strengthening exercises targeting the rotator cuff muscles can help improve shoulder stability and resilience to injury.
- Warm Up Before Physical Activity – Engage in a proper warm-up routine before engaging in repetitive or overhead arm movements, such as sports or weightlifting.
- Use Proper Lifting Techniques – When lifting heavy objects, use your legs instead of your arms to reduce strain on the shoulders.
- Avoid Repetitive Overhead Activities – Minimize activities that require repetitive overhead arm movements. These put excessive strain on the tendons over time.
- Take Breaks During Repetitive Tasks – If you engage in repetitive tasks, like painting or gardening, take frequent breaks to rest your shoulders and prevent overuse injuries.
- Listen to Your Body – Pay attention to any signs of shoulder discomfort or fatigue during activities and take appropriate breaks or modify your movements to prevent injury.
Incorporating these preventive measures into your daily routine can help protect your rotator cuff and reduce the risk of developing painful and debilitating shoulder injuries.
Next Steps
If you have experienced a rotator cuff injury or are exhibiting symptoms of one, please contact Dr. Peter Howard. He is an esteemed orthopedic surgeon and sports medicine specialist who has diagnosed and treated numerous rotator cuff injuries and conducted numerous arthroscopic procedures. Dr. Howard can provide a comprehensive evaluation, identify existing issues, and assess whether you are suitable for rotator cuff arthroscopy.