Northside Hospital

Ask The Doctors SUBMITTED BY NORTHSIDE HOSPITAL

Rotator Cuff Injuries

The rotator cuff is a group of muscles and tendons surrounding the shoulder joint that allow you to move your arm and shoulder. Rotator cuff injuries can range from being mild (requiring only over-the-counter pain medicine) to severe, which could lead to outpatient surgery.

Dr. Matthew Simmons

Dr. Matthew Simmons is a physician in family and sports medicine. He is the medical director of the Northside Cherokee Sports Medicine Program. He is a physician for Cherokee County School District Athletics and Reinhardt University, and he specializes in nonoperative orthopedics, concussion management, nonoperative treatments and sports injury prevention.

Dr. Stephen Rodes

Dr. Stephen Rodes is an orthopedic sports medicine surgeon. He has expertise in arthroscopic surgery treatment for shoulders, knees and elbow conditions. Currently, he is the lead orthopedic surgeon for the Cherokee County School District Athletics and Reinhardt University.

1.What types of injuries are associated with rotator cuffs?

Rotator cuff injuries may be as simple as sprains or strains of the cuff tissue, or more extensive injuries may be partial or full-thickness tears of the cuff. Sprains and strains are commonly diagnosed as bursitis or tendinitis.

2.How do you get rotator cuff tears? Rotator cuff tears can be the result of an acute traumatic injury or gradual wear and tear over time. Patients older than 45 are more prone to rotator cuff tears. Traumatic tears tend to occur with falls onto the shoulder or an outstretched arm. Degenerative (wear and tear) tears tend to occur in patients who do a lot of repetitive activities or manual labor, and they are more common in patients with systemic diseases, like rheumatoid arthritis.

3.What are the symptoms of a tear? The most common symptom is shoulder pain, often stemming from the side of the upper arm along the deltoid muscle. Many patients have pain that interferes with sleep and experience weakness and loss of motion, especially with larger tears.

3.What are nonoperative treatment options?

1.What are surgical treatment options? Surgical treatment is recommended for acute traumatic tears or chronic degenerative tears that fail to improve despite nonoperative treatment. Most surgeries are performed arthroscopically using small incisions and a camera to visualize the injury. The goal of the surgery for a complete tear is to reattach the torn tendon using a combination of plastic screws and sutures.

For a partial tear, it’s usually debrided, or cleaned up, and can be treated with a patch-type implant that is made from a cow’s Achilles tendon. Then, it’s attached to the torn rotator cuff with plastic staples. The patch itself dissolves over time, but it stimulates the body to heal the underlying tear.

2.How long is the recovery time from surgery, and what are the risks?

The surgery is outpatient, but it usually takes about six months to fully recover. Patients are put under general anesthesia for the surgery and receive a numbing injection along the bottom of the neck to limit pain postoperatively. Common risks after rotator cuff surgery include infection, stiffness, continued pain and failure to repair. The most common complication is retearing or failing to heal. This is TASTE OF WOODSTOCKinfluenced by the size of the tear, patient age, quality of the tissue, chronicity of tear, retraction and muscle atrophy.

Nonoperative treatment is typically the initial treatment for most atraumatic tears. The options include nonsteroidal anti-inflammatory drugs (such as ibuprofen), avoiding overhead activity and heavy lifting, physical therapy and steroid injections. Nonoperative treatment is effective in many cases, especially in partial tears. 3.How do I know if my repair healed? Healing is monitored by pain levels, improving, regaining motion and a strong rotator cuff. If the patient isn’t progressing as expected, then magnetic resonance imaging will be performed to check for healing.