A rotator cuff tear is one of the most common causes of shoulder pain. Your rotator cuff is a group of tendons in the shoulder joint which provide support and enable flexibility for a wide range of motion. When your rotator cuff is torn, the tendons pull away from the head of the humerus, the bone in your upper arm. A rotator cuff tear can result from normal degenerative wear and tear with age or major injuries such as excessive overhead sports activities.
Signs that your rotator cuff may be torn are: severe shoulder pain, weakness in your arm, restricted motion, swolling, and tenderness. Speaking to your doctor as soon as these symptoms arise will allow you to explore the best recovery track for you.
Depending on the severity of your tear, most doctors will recommend non-surgical intervention first to help relieve your symptoms, typically with the following recommendations and treatments:
- Rest
- Pain medication or injections to reduce swelling and discomfort
- A sling to reduce the possibility of further tearing and allow healing
- Targeted exercises or physical therapy
However, conservative non-surgical intervention is not always effective in alleviating your symptoms and returning your shoulder to its optimal functioning. Here are some signs and reasons you should consider rotator cuff surgery:
- Persistent pain and symptoms for more than 6 months. When non-surgical treatments have failed to alleviate your pain and your discomfort continues for long periods of time, it may be wise to look at surgical options.
- Significant weakness and loss of function in your arm and A healthy arm and shoulder allow a wide range of movement and functioning. If your shoulder is not functioning at optimal performance, you should ask your doctor how surgery could improve this.
- High dependency on your arm and If you are an athlete or your job is physically demanding, normal functioning of your arm and shoulder is critical for proper performance. If your day-to-day life is severely impacted by your injury, surgery may help to return your shoulder to optimal performance faster and more effectively.
- Severity of your Depending on the severity and complexity of your tear, your physician may or may not recommend surgery. But typically, if your tear is larger than 3 cm, surgery should be considered since conservative treatments may not be sufficient for healing.
Rotator cuff surgery can either be performed via open or arthroscopic surgery. Traditional open surgery may be performed if the tear is large and complex. More commonly, arthroscopic surgery is utilized. Arthroscopic repair is a minimally invasive surgery that can allow for fast recovery and minimization of complications. If surgery is indicated, discuss with your physician which type of surgical intervention is right for you.
Rotator cuff tears are common, but surgery is not always necessary. However, when alternative conservative options have been explored and pain and minimal functioning is still present, ask your doctor if rotator cuff surgery is right for you.
Dr. Kai Mithoefer is board certified in both Orthopedic surgery and Orthopedic sports medicine, fellowship trained in Orthopedic Trauma at Harvard and the prestigious Sports Medicine and Shoulder Surgery fellowship at the Hospital for Special Surgery in New York. Dr. Mithoefer is an internationally recognized specialist for joint preservation, has published more than 100 scientific articles and book chapters and is a frequent speaker at national and international orthopedic meetings.
