The rotator cuff is composed of four muscles and their tendons that are located in the shoulder, and which enable the upper arm to rotate. It also stabilizes the shoulder joint by keeping the ball of the arm bone attached to the socket of the shoulder blade. When one of the tendons is torn or injured, you will experience pain in the shoulder and down the arm, and it will be difficult to lift your arm above the head. Weakness in the affected shoulder and pain at night when sleeping are also common.
Symptoms may be treated with conventional methods, which consist of rest, ice therapy, oral pain medications, and rehabilitative exercises. However, if these are not effective in relieving symptoms, surgery may be needed.
Rotator cuff surgery often involves repair of the torn tendons either through an arthroscopic procedure, using a small incision, or an open shoulder surgery done under nerve block or general anesthesia.
Some reports show that surgery may result in 90% success rate, but some studies show that healing fails in 20 to 40% of patients.
What to Expect after Rotator Cuff Surgery
Just like any surgery, pain, swelling, and discomfort are common after rotator cuff surgery. Other possible complications include bleeding, infection, and nerve damage. In most cases, pain may be relieved by taking oral pain relievers and rest. Long term complications include failure to repair large tendon tears, repeat surgeries, and joint stiffness. The likelihood of success is greater when the tear is small and if the surgery is done within a few weeks after injury to the rotator cuff.
After surgery, the joint is often immobilized with a sling for a definite period (six to 12 weeks, depending on the injury and extent of surgery done). Healing of a torn tendon is relatively slow because blood supply is lacking in this area.
Passive exercises may be done, as well as daily activities like writing, eating, and drinking, by moving only the elbow and wrist. Guided physical therapy exercises must be done regularly to prevent scarring and joint stiffness. However, driving, lifting, pushing, and pulling must be strictly avoided. Apply ice over the joint after physical therapy exercises.
Active exercises and stretching without the sling may be done after several weeks, depending on how extensive the surgery was, and after a few months, strengthening exercises using small weights may be started.
Surgery for large rotator cuff tears or injuries that involve more than one tendon may be less be successful, and may lead to repeated surgeries or failed treatment. On the other hand, some people who do not have their rotator cuff tears surgically repaired develop arthropathy, which results in progressive joint pain and significant loss of flexibility, strength, and function.
Some factors must be considered when deciding if rotator cuff surgery is needed, such as age and level of activity. Sometimes, conservative treatment and less invasive procedures may be enough to relieve pain and restore function in daily activities.
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