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Rotator cuff tears are common after falls onto an outstretched arm or lifting something too heavy. But not all tears are due to injuries; degenerative tears happen when a tendon is worn down over time, often by repetitive motions or bone spurs. Today one hundred percent of rotator cuff surgeries are done with an arthroscopic approach. The traditional rotator cuff surgery is done without the arthroscope slows and limits your recovery. If a traditional surgeon tells you that surgery is needed but it can’t be done using a minimally invasive arthroscopic approach, then it’s a good idea to get a second opinion.
If you think you have a rotator cuff tear you should put your arm in a sling and make an appointment to see your chiropractor, physical therapist, or primary care physician. If your pain is so severe you can’t sleep, your shoulder is swollen, stuck in the wrong position then you should see an orthopedic surgeon directly. There’s generally not much sense in going to the Emergency Department or urgent care for shoulder pain.
Surgery is recommended for complete rotator cuff tear, and for incomplete tears that fail to heal adequately without surgery. Continuing to use your shoulder after a rotator cuff tear can make the tear worse, further damaging your shoulder.
If surgery is needed be reassured that major surgery is not required. Arthroscopic rotator cuff repair can be done in an ambulatory surgery center, so hospitalization is not required. The surgery takes 90 – 120 minutes and is usually done under a general or regional anesthetic. Your arm is placed in a sling in the recovery area.
Be sure to wear your sling after your arthroscopic rotator cuff tear surgery. The rotator cuff muscles were sewn back together during the surgery, and they need to heal back. The healing process takes months to be complete. There are several do’s and don’ts after rotator cuff repair surgery.
- Wear your sling (provided at the time of surgery) at all times —except when you are bathing, doing your prescribed exercises, or getting dressed— for 4-8 weeks, depending on the size of the tear that was repaired, and the type of repair done.
- Avoid internal rotation of your shoulder except as instructed in these exercises. Internal rotation is the movement of putting your hand behind your back.
Arthroscopic rotator cuff tear repair restores range of motion in your shoulder and eliminates the pain after rotator cuff tear. The procedure is minimally invasive, and can be done in an Ambulatory Surgery Center, so risky hospitalization is not needed. You do need to wear a brace for 4-8 weeks after the procedure, and rehabilitation is required. But once it’s all done, you can’ count on getting back to a full night’s sleep without shoulder pain.
The first clue you have a rotator cuff tear is shoulder pain at night that makes it hard to sleep. The muscles of the rotator cuff primarily move the shoulder to raise your hand like you are asking a question in class, and put your hand behind your back https://youtu.be/iGctIedO29w. If these movements reproduce your usual shoulder pain, then there’s a good chance you have a rotator cuff tear.
The best test to determine if you have a rotator cuff tear is magnetic resonance imaging (MRI) (https://youtu.be/62t-5V6Qj94). The physical examination is suggestive, but not definitive. Traditional x-ray doesn’t show the muscles of the rotator cuff and therefore can’t be used to visualize a tear. CT scan is not as sensitive as the MRI, but it’s a reasonable alternative test if you can’t have an MRI.
Rotator cuff tears can be partial or full thickness. A partial tear may be able to heal by itself over 4-6 weeks. If you have pain in the front of your shoulder at rest at night that keeps you from sleeping and is reproduced by raising your hand or putting your hand behind your back, then you should suspect a rotator cuff tear. If the pain is severe, you have swelling, and you can’t sleep then see an orthopedic surgeon right away. It the pain is not that bad then you can try non-steroidal anti-inflammatory drugs (NSAIDS like Aleve or ibuprofen) with Prilosec to protect your stomach, and schedule to see your chiropractor or primary care doctor within a week or two. Your doctor will obtain x-rays. If the x-ray does not indicate advanced arthritis, then you should see an orthopedic surgeon in consideration for arthroscopic rotator cuff repair.
If you think you have a rotator cuff tear you should put your arm in a sling and make an appointment to see your chiropractor, physical therapist, or primary care physician. If your pain is so severe you can’t sleep, your shoulder is swollen, stuck in the wrong position then you should see an orthopedic surgeon directly. There’s generally not much sense in going to the Emergency Department or urgent care for shoulder pain.
Surgery is recommended for complete rotator cuff tear, and for incomplete tears that fail to heal adequately without surgery. Continuing to use your shoulder after a rotator cuff tear can make the tear worse, further damaging your shoulder.
If surgery is needed be reassured that major surgery is not required. Arthroscopic rotator cuff repair can be done in an ambulatory surgery center, so hospitalization is not required. The surgery takes 90 – 120 minutes and is usually done under a general or regional anesthetic. Your arm is placed in a sling in the recovery area.
Be sure to wear your sling after your arthroscopic rotator cuff tear surgery. The rotator cuff muscles were sewn back together during the surgery, and they need to heal back. The healing process takes months to be complete. There are several do’s and don’ts after rotator cuff repair surgery.
- Wear your sling (provided at the time of surgery) at all times —except when you are bathing, doing your prescribed exercises, or getting dressed— for 4-8 weeks, depending on the size of the tear that was repaired, and the type of repair done.
- Avoid internal rotation of your shoulder except as instructed in these exercises. Internal rotation is the movement of putting your hand behind your back.
Be sure to wear your sling after your arthroscopic rotator cuff tear surgery. The rotator cuff muscles were sewn back together during the surgery, and they need to heal back. The healing process takes months to be complete. There are several do’s and don’ts after rotator cuff repair surgery.
- Wear your sling (provided at the time of surgery) at all times —except when you are bathing, doing your prescribed exercises, or getting dressed— for 4-8 weeks, depending on the size of the tear that was repaired, and the type of repair done.
- Avoid internal rotation of your shoulder except as instructed in these exercises. Internal rotation is the movement of putting your hand behind your back.
In order to keep your repair safe after arthroscopic rotator cuff repair surgery the exercises are all passive in nature. Here are the exercises you should do.
The pendulum | External rotation with a cane | Shoulder rolls | Active stretches for your elbow wrist and hand.
The goal for weeks 6-12 after arthroscopic rotator cuff repair is to return normal range of motion to you shoulder. This is done with several exercises. Repeat each movement (exercise) 10-15 times, rest, then do the repetitions again 2 more times for a total of 3 sets of 10-15 movements for a total of 30-45 movements.
- Sleeper stretch. Lay on your side and gently push the arms closest to the floor downward. Avoid putting pressure on your hand, this will just move your wrist. This movement helps restore internal rotation of your shoulder.
- External rotation. Hold the door with your hand and gently rotate your body. This causes your shoulder to rotate your arm away from your body.
- Standing Y. Face the wall, raise your hands above your head so your arms make the letter Y, and retract your shoulder blades backward. Avoid shrugging your shoulders; you want your shoulder blades to move backward and together.
- Banded row. Secure a band to a door or post and hold the edges with your arms in front of you. Pull backward so your elbows bend at ninety degrees. Don’t let your arms go up or down from the ninety-degree line. Mind your form: avoid shrugging your shoulders, rounding your back, letting your chin move forward, or letting your elbows move too far behind your back.
- Standing rotation. Place a rolled-up towel in your arm pit and secure a band to a chair or door. Rotate your arm inward while keeping your elbow at ninety degrees. For external rotation use your arm away from the band, tuck the towel in your arm pit, start with your hand at your belly button then rotate your arm away from your body. Mind as you get tired that you don’t turn your whole body, rotate your arm.
