Clinically, people will start experiencing pain and weakness. Athletes who play sports that require a lot of overhead activity are at a high risk for sustaining a rotator cuff tear. These tears can result from a single traumatic event—such as a sudden fall on your shoulder or a collision with an object or another player—or the tears can develop gradually because of repetitive overhead motions like pitching or throwing a ball.
Many times, rotator cuff tears can be treated with conservative methods such as anti-inflammatory medication, steroid injections, and physical therapy. If the tear is complete, meaning that there are no longer any fibers attached to the bone, it is likely that your rotator cuff will not heal on its own—in these cases surgery is recommended. Conservative treatments and surgical treatments alike are designed to restore strength, functionality, and mobility to the involved shoulder and relieve your shoulder pain.
Your orthopedic surgeon will help you decide the best plan of action for your shoulder. In majority of the recovery can take 4 to 6 months or longer, depending on the size of the tear. Most activities can be resumed at 6 months, however the rotator cuff will heal for up to a year. Rehabilitation plays a critical role in recovery—no matter if you are choosing nonsurgical or surgical treatment options. Proper rehabilitation to strengthen your rotator cuff muscles and your periscapular muscles will decrease her overall recovery time and help you reach your maximum function.
If surgery is the best solution for your tear, you may have to wear a sling for four to six weeks after surgery. Most people are involved in physical therapy for months after surgery.
Over time, you go to physical therapy less frequently, but continue to do a home based program. Your orthopedic surgeon can talk through your options with you at length to discover the best program for you, based on your needs. What positions should I rest my arm in after surgery? Not all rotator cuff repairs are the same and a physician may modify your postoperative care based on what was done during surgery. Most repairs are placed in a sling with a pillow to wedge the arm away from the body and take some tension off the rotator cuff repair.
The rate of progression from that point is determined by the surgeon in light of the quality of tissue found at the time of surgery. Once the shoulder has a nearly full range of motion strength and comfort the patient may progressively resume activities. It is important to recall however that even with a solid and complete repair and with good healing the tendon will remain susceptible to re-injury for up to a year after surgery.
Like all surgeries rotator cuff surgery can be complicated by infection nerve or blood vessel injury fracture instability and anesthetic complications. Furthermore this is a technically exacting procedure and requires an experienced surgeon to optimize the bony prosthetic and soft tissue anatomy at the procedure.
The most common causes of failure are 1 failure of a rotator cuff repair to heal or 2 scar tissue that limits the range of motion after the procedure. If this is not the case a smooth and move procedure may help restore comfort and function. We currently perform approximately 60 of these procedures each year on carefully selected patients from across the United States. Because this procedure is not performed in many centers across the United States patients often come to Seattle from a long distance for the procedure.
Seattle on Mondays and Fridays to evaluate individuals with shoulder arthritis to discuss the procedures that might be most ideally suited for them. Patients having rotator cuff surgery are usually able to return home three days after the procedure assuming they have mastered their exercises. Ideally we like to see patients back at six weeks after surgery to assure that satisfactory progress is being made.
We request that patients complete questionnaires at 3, 6, 12, 18 and 24 months after surgery so we can track their progress and that the patient obtain and send to us X-rays at 12 and 24 months after surgery if they are unable to return to Seattle for the annual follow-ups.
All patients have our personal email and the clinic contact phone numbers to use in contacting us at any time questions arise. Frederick A. Howe C. Am J Sports Med 37 2 : Fehringer E. J Shoulder Elbow Surg 17 6 : Largacha M. J Shoulder Elbow Surg 15 1 : McCallister W. J Bone Joint Surg Am 87 6 : Churchill R.
J Am Acad Orthop Surg 12 1 : Harryman D. Goldberg B. Clin Orthop Relat Res : Smith K. J Shoulder Elbow Surg 9 5 : Norquist B. J Bone Joint Surg Am 82 6 : Duckworth D. It has been shown the majority of re-tears following cuff repair happen in the first 6 months following surgery and recurrent tears that occur more the 1 year after successful healing are unusual. The rate of progression and ultimate limitations for these patients must be individualized based upon progress in rehabilitation and return of cuff strength.
Jay D. Keener, MD, is an associate professor, chief of Shoulder and Elbow Service and fellowship director in the department of orthopedic surgery at Washington University, in St. Disclosure: Keener reports he received a grant from the NIH. Issue: March By Jay D. Keener, MD. Read next. March 15, Receive an email when new articles are posted on. Please provide your email address to receive an email when new articles are posted on.
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