What is the rotator cuff?
The rotator cuff is a group of 4 muscles and tendons (supraspinatus, infraspinatus, subscapularis and teres minor) responsible for the stability and movement of the shoulder. Apart from its role as a rotator of the shoulder, the integrity and contraction of the rotator cuff muscles keeps the ball of the joint centered on the socket.
What are rotator cuff tears?
Rotator cuff repair fixes tears that are disruptions in the continuity of any of the 4 rotator cuff tendons. This may be caused by injury (traumatic) or age related (degenerative or “wear and tear”). Rotator cuff tears are more common in patients over the age of 40.
The supraspinatus is the most commonly torn tendon and the symptoms felt by patients vary from severe pain and functional impairment, to no symptoms at all. Partial tears may heal naturally but full thickness tears do not, however many patients learn to compensate with other muscle to function normally. We do not yet understand why some patients experience problems and some do not.
What are the symptoms of rotator cuff tears?
The most common symptom is pain and weakness when lifting the arm overhead. Typically the pain is better with rest and worse with movement. For large tears, patients may not be able to lift the arm at all without help.
What is the treatment for rotator cuff tears?
Pain relief and a good level of function may be achieved with medication, injections into the shoulder and physiotherapy to help with mobility and strength of the shoulder. However, for those with ongoing problems, a recent large UK study (The UKUFF Trial) has shown that rotator cuff repair surgery is effective in reducing pain and improving function.
Some tears can progress (become larger) over time and can be accompanied by arthritis in the shoulder over time if not repaired.
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What type of surgery is involved, and what to expect?
There are a number of ways to treat rotator cuff tears. These include open, mini open and arthroscopic keyhole techniques.
Our surgeons preference at Melbourne Arm Clinic is to use an arthroscopic keyhole technique. It allows the surgeon to treat all coexisting pathologies with the same small incisions whilst providing a more rapid recovery.
Rotator cuff repair a torn rotator cuff most often involves re-attaching the tendon to the bone, however if there are additional problems such as arthritis or the tear is too large to repair, alternative surgical options may be required. We will discuss this with you, to explore the best procedure to meet your individual presentation.
How long is recovery after a rotator cuff repair?
Your first 4 weeks after surgery you will be in a sling. You will not be able to drive for 6 weeks, and you won’t be able to lift anything for 3 months, and heavy lifting after 6 months. If you job requires lifting, our surgeon will discuss with you on how much time off work after rotator cuff surgery will be required.
Rotator Cuff Rehab will be required to help get movement back into the shoulder. You can start breaststroke swimming at week 6 and play golf from 4-6 months.