Rotator Cuff Injuries and Solutions
The rotator cuff is made up of four tendons (subscapularis, supraspinatus, infraspinatus, and teres minor) that work to hold the humeral head (the ball part of the joint) in the socket, which allows motion. Due to high volume daily use, rotator cuff injuries are very common.
When the rotator cuff is torn, weakness and pain can occur. Over time, especially with a large rotator cuff tear that is not repaired, a certain type of arthritis can occur. Rotator cuff disease is also common, and it encompasses impingement, subacromial bursitis, rotator cuff tendonitis, and rotator cuff tears.
The goal of rotator cuff repair is to improve pain, function, and mobility. Rotator cuff injuries can now be treated arthroscopically, which allows for a quicker recovery and less postoperative pain.
Shoulder impingement occurs when bone spurs rub on the rotator cuff. Pain may be caused when the arm is in the overhead position. Shoulder impingement may also contribute to the rotator cuff tearing over time.
Many patients with impingement can be treated nonoperatively with activity modification, exercises, physical therapy, anti-inflammatory medicines, and/or steroid injections.
If these measures are not successful then patients may be candidates for arthroscopic surgery. During this surgery, the bone spurs can be removed from the acromion and, in some cases, the distal clavicle may require removal as well. This can all be done in a minimally invasive fashion with arthroscopy.
Arthroscopic Rotator cuff repair
Rotator cuff tears are common causes of shoulder pain and weakness. Arthroscopic repair allows the rotator cuff to be completely repaired through small incisions, using a camera and small instruments. This allows us to see the rotator cuff tear even better than through an open incision, and also causes less muscle damage and pain. This improves post-operative recovery and better maintains the integrity of the surrounding tissues.
Post-operative patients are usually in a sling for 6 weeks. Strengthening begins 3 months after surgery, and full recovery takes 6-12 months.
Calcific tendonitis occurs when calcium deposits are present within the rotatora cuff. This can cause severe shoulder pain. Sometimes it can get better with injections, but if not surgery is an option. Surgery involves arthroscopic removal of the calcium and usually, repair of the area of tendon that the calcium was removed from.
Post-operative rehabilitation and recovery is very similar to that of a rotator cuff repair.