Dr. Lee says with time, large tears can become irreparable due to tear enlargement, scarring and muscle atrophy.
Article Link: Torn Rotator Cuff: Signs, Symptoms and How to Heal | Conditions | U.S. News (usnews.com)
Torn rotator cuffs are sometimes painful and can have a major impact on your quality of life. Read about the symptoms, causes and treatment options for this common shoulder injury.
A torn rotator cuff is a common shoulder injury that affects more than 2 million people in the U.S. each year, according to the American Academy of Orthopaedic Surgeons.
While rotator cuff tears can’t heal on their own, nonsurgical treatments can help boost your shoulder’s function and lower pain.
Key Takeaways
- A torn rotator cuff may cause pain while performing daily activities or exercising, but some people may not experience any symptoms after tearing their rotator cuff.
- Doctors can diagnose a torn rotator cuff by doing a physical examination, ultrasound, x-ray or MRI. These exams will help them determine the severity of the tear.
- Pain from a torn rotator cuff may be helped by physical therapy. However, some peoples’ torn rotator cuffs may need surgery.
The term rotator cuff refers to the muscles and tendons that connect to keep your arm in its shoulder socket and to help lift and rotate the arm. A torn rotator cuff occurs when there’s a tear in these tendons.
Treatment for a rotator cuff tear may or may not involve surgery, and the treatment chosen is based on the amount of pain and the type and extent of the tear.
Physical therapy often plays a major role in helping someone regain strength and motion from a rotator cuff injury, although it won’t heal a tear.
“The goal of physical therapy in treating a torn rotator cuff with or without surgery is to restore functional shoulder mobility and strength to eliminate pain and return to usual activities,” Marner says.
Physical therapy is commonly used after rotator cuff surgery for as long as three to six months. When searching for a physical therapist, look for someone who’s experienced in treating shoulder injuries and rotator cuff tears. Your surgeon can likely recommend a particular physical therapist for your recovery from surgery that also works with your insurance.
Other treatments to help pain or inflammation from a torn rotator cuff include:
- A cortisone injection. This can lower inflammation and pain, but it won’t cure the rotator cuff. If used too often, it could worsen the tear.
- Platelet rich plasma injections. This is a type of therapy made from a patient’s blood that is then injected into an injured area. The treatment is rich in plasma and can help heal an injury more quickly.
- Bone marrow aspirate injections, which use an injection of a patient’s bone marrow (the spongy tissue deep in the bones) to lower inflammation and help provide normal function to joints and tendons.
- Nonsteroidal anti-inflammatory drugs. These NSAID drugs, like Advil and Aleve can help reduce pain associated with the injury, but will not help heal the tear.
- An arm sling. In some cases, a doctor may recommend use of an arm sling to immobilize the shoulder and allow the arm to heal.
Options like platelet rich plasma injections and bone marrow aspirate injections may help patients looking for more natural treatment options, but they won’t cause reattachment of a fully torn, retracted rotator cuff tendon.
“I always take the time to discuss what the potential consequences of leaving a tendon torn could be,” says Dr. Brian Lee, an orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles and an orthopedic consultant for the PGA Tour. “With time, large tears can become irreparable due to tear enlargement, scarring and muscle atrophy.”
Surgery, typically performed as an outpatient procedure at an ambulatory surgery center or hospital outpatient department, is another option for a rotator cuff tear if someone isn’t responding to conservative, nonsurgical treatments. A surgeon will perform rotator cuff surgery arthroscopically, which means making small incisions and using a small tube with a camera called an arthroscope to reach the site of the tear. Surgeons then use special instruments to repair the rotator cuff.
When choosing an orthopedic surgeon for a rotator cuff repair, look for a shoulder specialist as they will have more familiarity with treatment options tailored to you.
“If a tear is not repairable, a specialist can typically make the decision during surgery to perform an alternate reconstructive procedure,” Lee says.
Recovery time for surgery may depend on a person’s activity level, age and size of the tear, Lee says. Generally speaking, you should be able to return to normal activities six to eight weeks after surgery and when you begin rehabilitation exercises. You’ll need to wear a sling for the first few weeks of your recovery.
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