Tag Archives: rotator cuff

How To Treat Rotator Cuff Injuries

Rotator Cuff Treatment

Often with Rotator Cuff injuries your doctor or therapist will advise complete rest or extremely limited activity, followed by gradual shoulder strengthening exercises and physical therapy.

There are several treatment options for rotator cuff tears.

Non-surgical rotator cuff tear treatments include using a sling for the affected arm, medication to relieve the pain and inflammation, and steroid injections.

Rotator Cuff Surgery

Rotator Cuff Surgery may be required if non-invasive treatments fail.

For further information see the following Rotator Cuff articles:

Rotator Cuff Surgery

Rotator Cuff Tear

Rotator Cuff Treatment


What Causes Rotator Cuff Tear?

Causes of Rotator Cuff Tear

A torn rotator cuff is often caused by a sudden and acute fall.

People most likely to suffer a torn rotator cuff are those whose jobs involve repetitive overhead movement, such as construction, stocking shelves or even painting.

Swimmers, tennis players, pitchers and other athletes, where their sport  continuously stretches the upper body, are also very susceptible to injuries rotator cuff tears.

People suffering from prolonged or repetitive trauma are also likely to suffer rotator cuff injuries. It is also common among people who have shoulder dislocation or shoulder fractures.

For further information see the following articles:

Rotator Cuff Tear

Rotator Cuff Treatment

Rotator Cuff Surgery

Arthroscopic Rotator Cuff Surgery

With Arthroscopic  surgery the Rotator Cuff repair  is done by a series of small cuts around the shoulder. Flexible wires called “portals” are introduced through the cuts. These enable the surgeon to see and assess the shoulder damage.

Removal of spurs from the underside of the acromion and repair of the rotator cuff tear are done through the portals themselves using flexible wires capable of carrying various cutting and suturing instruments within themselves in to the joint. This procedure requires a highly proficient and experienced orthopedic surgeon.

Advantage of arthroscopic surgery

The advantage of arthroscopic surgery is that postoperative pain, recovery and rehabilitation are comparatively better. But open shoulder surgery and mini open surgeries provide assured and long term results, especially if the initial rotator cuff tear is very large.

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Mini Open Repair Rotator Cuff Surgery

Mini open repair Rotator Cuff Surgery is a cross between the open and arthroscopic repair.

With Mini open repair the incision is only about 4 cm long. The deltoid muscle is not cut open in this method. Instead, an arthroscope is used to assess the damage and remove the bony fragments of spurs in the underside of the acromion.

Subsequently, the torn rotator cuff tendon is reattached to the humeral head. The incision is then closed in layers.

An advantage of mini open rotator cuff surgery is that recovery is generally quicker than with fully open surgery.

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Open Repair Rotator Cuff Surgery

In open repair rotator cuff surgery a small incision of is made over the shoulder joint. The deltoid muscle, which covers the shoulder joint, is exposed. It is then cut to gain access to the tear.

Re-attaching of the torn rotator cuff tendon to the bone closes the tear. Any bony fragments or spurs are also removed during the procedure. The deltoid muscle is again sutured together. Then the tissues under the skin, and finally the skin are closed.

The results of open rotator cuff surgery provide are generally very good, but disadvantages are that compared to arthroscopic surgery the postoperative pain can be worse, and recovery and rehabilitation takes longer.

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Rotator Cuff Surgery Options

Shoulder surgery is sometimes necessary to treat rotator cuff injuries such as rotator cuff tears. For example, if the rotator cuff injury is accompanied with a decrease in strength of the affected shoulder joint then the injury may require surgery.

There are three different types of shoulder surgery for rotator cuff injuries. These are

1. Open rotator cuff repair
2. Mini open rotator cuff repair
3. Arthroscopic surgery

In my next posts I will examine these different types of rotator cuff surgery in more detail.

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Alternatives to Rotator Cuff Surgery

What are the alternatives to Rotator Cuff Surgery?

Rotator cuff repairs can be achieved by surgery, but in some cases surgery may not be necessary to repair the rotator cuff.

Non-surgical treatment is usually appropriate for people who suffer from shoulder pain without a decrease in shoulder strength caused by the rotator cuff injury.

There are three main non-surgical options for treating rotator cuff injuries. These are:

1. Avoiding pain inducing activities
2. Pain relief injections
3. Perform shoulder exercises

Avoiding pain-inducing activities can itself lead to increasing stiffness and frozen shoulder.

Injections can result in reduced pain and stiffness, but the improvement is temporary. In addition there is the risk of side effects such as infection.

Shoulder pain exercises are usually the best non-surgical option, but the level of success will depend upon the amount of arthritis present under the acromioclavicular joint of the shoulder.

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Do you Need Rotator Cuff Surgery?

Before deciding to have Rotator Cuff Surgery make sure that you have considered other treatment options such as shoulder exercises and pain relief injections first.

Shoulder surgery is however sometimes required for rotator cuff tears, especially if accompanied with a decrease in strength of the affected shoulder joint. There are three types of surgical repair:

1. Open repair

2. Mini open repair

3. Arthroscopic repair

All of the above methods give fairly similar improvement in pain, functional level and patient satisfaction. The choice of the procedure really depends upon the proficiency of the surgeon, anatomy of the involved area and cosmetic considerations.

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Do you suffer from Shoulder Tendonitis, Bursitis, or Impingement?

What are Shoulder Tendonitis, Bursitis and Impingement?

Shoulder tendinitis, shoulder bursitis, and impingement are actually all closely linked.

Tendonitis is the inflammation of a tendon. In the shoulder, tendinitis usually affects the tendons of the biceps or rotator cuff as a result of pinching from surrounding structures.

When tendinitis affects the rotator cuff, the inflamed tendon may swell and get trapped beneath the acromion, making shoulder movement extremely uncomfortable. This is called shoulder impingement.

Bursitis is inflammation of the bursae. The bursae are fluid-filled sacs found next to tendons or large joints. They are used to make movement easier, inflammation often occurring in conjunction with tendonitis.

To find out more information please click the links below:

Shoulder Tendonitis

Shoulder Bursitis

Shoulder Impingement

Kind Regards,
Tim Allardyce DO MCSP SRP

Exercises For Shoulder Pain

 

 

Rotator Cuff Tear Symptoms

Rotator cuff tear symptoms usually show up slowly. Pain may be really mild at first and gradually increases.

The pain is usually felt at the front of your shoulder and spreads down the arm. Mild shoulder pains are often ignored and treated with over the counter prescriptions. However, in the case of rotator cuff tear, the pain gradually increases and is felt even with very little activity or at rest. Treatment and even rotator cuff surgery may be required.

You might feel pain while lying down on the affected side. Stiffness and consequent loss of
motion result.

For further information about rotator cuff tears please click the link below:

Rotator Cuff Tear