Treating a Rotator Cuff Tear
Dr. Kenneth Montgomery, sports medicine doctor at Tri-County Orthopedics, describes a rotator cuff tear and treatment options available.
Dr. Montgomery: Hi. I'm Dr. Ken Montgomery from Tri-County Orthopedics. I'm an orthopedic surgeon who specializes in sports medicine as well as hand and upper extremity surgery.
The rotator cuff is a group of four muscles that surrounds the upper part of the shoulder. These muscles are important for helping lift your arm above your head. Rotator cuff tear occurs when one or more of these muscles is torn.
Rotator cuff tears can occur in a variety of ways. They occur frequently after a fall or an injury that occurs when we're trying to lift something heavy above our head, but they can also occur slowly over time, just simply as a matter of wear and tear for somebody who does a lot of activities or sports.
The diagnosis of a rotator cuff tear is made when you see your physician, a history is taken as well as a physical examination, which usually will suggest the rotator cuff tear may be there. Ultimately an MRI can be very helpful in helping to define the size of the tear and help determine the best approach moving forward.
When surgery is indicated for a rotator cuff tear, it can be done either as an open procedure or an arthroscopic procedure. The open procedure involves making a small incision on the front of the shoulder and then taking the end of the tendon and sewing it back down to the bone. The arthroscopic procedure is a minimally invasive procedure that essentially does the same operation but through very small incisions in a less invasive technique.
The advantages of shoulder arthroscopic to repair the rotator cuff over the open procedure is that because it's less invasive it tends to be less painful, there's less bleeding, and that can make it so that the patient's more comfortable in the first few days after surgery. There's less scar tissue, and that can speed the patient's recovery and get them back to their daily activities more quickly.
After shoulder arthroscopy, we ask the patient to carefully use their sling for at least the first four to six weeks. There's some simple home exercises that we'll often give the patient so that they can get some gentle range of motion in the shoulder to prevent stiffness. We ask them to take the pain medications, certainly, for the first couple of days so that they're comfortable, and then usually they'll come back to see us about a week after surgery so that we can check on their incisions, remove their sutures, and often begin their physical therapy.