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Of musculoskeletal injuries, rotator cuff injuries are one of the most frequent. A rotator cuff injury is quite painful and can cause shoulder weakness; however, it does not cause swelling. Interestingly, patients often do not have symptoms. Most of the time; however, the patient will experience pain and weakness during activities involving the arms. Raising the arm above shoulder level can prove particularly painful. On the bright side, there are quite a few ways to treat rotator cuff injuries. Your age and the type of injury you have will help determine which option will work best for you.

There are two categories of rotator cuff injury. One is rotator cuff tendonitis. The other is rotator cuff tear. Be aware that there are several other conditions that could be the cause of shoulder pain. The only way to get an accurate diagnosis of rotator cuff injury is to see a doctor. He or she will first look at the symptoms and perform a basic physical examination. After this, the physician may use a local anesthetic that will be injected into the injured shoulder. This will help determine whether the injury is a muscle tear or tendonitis. If the injury seems to be a rotator cuff tear, the doctor may order some imaging tests. These will help confirm that the injury is a tear and isolate the location of the injury.

Rotator cuff tendonitis is more common than rotator cuff tear, but the treatment is similar for both. Rest, ice, compression and elevation, also known as RICE therapy, is prescribed for both conditions. Your doctor may also tell you to take an over-the-counter pain medication like ibuprofen. You may also be referred to a physical therapist who will help you to understand how to modify your activities to avoid pain and may also give you instructions on exercises to help strengthen your shoulder. If these measures dont help, your doctor may give you a shot of a steroid/anesthetic mix. This injection will be made directly into the joint to help address your pain.

About half the patients using this kind of non-surgical treatment experience an increase in ROM (range of motion) and a decrease of pain within 2 or 3 months. This kind of treatment has several advantages. First of all, non-invasive treatment avoids surgical risks such as infection, anesthesia complications, and permanent stiffness. Second, there is no recovery time involved. Of course, there is also a downside in that this route could lead to an increase in the size of the tear. Additionally, the patients activity level may be decreased during the healing period. And, there is the risk that a non-invasive method may simply not work. If this is the case, and the non-invasive option fails, then surgery may be the alternative. The doctor may also decide that surgery is the better option if he or she feels that the injury is severe enough to merit it as the first option.

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There are three ways to treat a rotator cuff injury surgically:

1. Open repair surgery: With this option, the surgeon makes a full incision into the shoulder. This method gives the surgeon a great deal of freedom of movement; however, it is the largest incision option of the three available methods.

2. Mini-open repair surgery: This method is like open repair surgery, but it also utilizes arthroscopy. The advantages of this method are that it is an outpatient procedure that leaves a smaller scar.

3. All arthroscopic surgery: This option is an outpatient procedure, and it uses the smallest incision.

Your doctor will need to give you a thorough examination and do complete testing to determine which type of surgery will be best in your case.

Happily, rotator cuff surgery is a highly successful surgical procedure. Eighty to ninety-five percent of patients who have this type of surgery report successful results, improved range-of-motion and a significant decrease in pain in six months or less.

The success of your recovery is dependent on a number of factors. Among them are, your surgeons level of expertise, your fitness level, the severity of your injury, and your compliance with your doctors instructions.

Some patients experience complications from surgery; however, these are rare. One to two percent may experience nerve injury. Approximately one percent may contract infection. Less than one percent may have detachment of the deltoid muscle. Less than one percent may experience stiffness. Tendon re-tear is experienced by approximately six percent of patients.

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Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Oregon ACL Tears and Oregon Knee Surgery.

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