The rotator cuff is a set of 4 muscles at each shoulder. These muscles work together to keep the “ball in socket” as you move your arm out or overhead. If the tendon of one of these muscles is injured, it will be painful for you lift anything, reach overhead, or reach behind your back. The rotator cuff tendons can be injured traumatically in a fall or other accident or be worn down over time by repetitive activity or use of poor posture. Although the injured tendon is in the shoulder, pain from the rotator cuff is most commonly felt in a band around the upper half of the upper arm. A rotator cuff injury can often be diagnosed based on clinical presentation, but if conservative treatments do not resolve the issue, an MRI may be ordered to determine which of the tendons are involved and whether they are torn or just inflamed.
Rotator cuff symptoms are addressed by conservative treatments initially. These can include use of anti-inflammatory medication, physical or occupational therapy intervention, avoidance of aggravating activities, and possibly use of a steroid injection. If the injured tendon is only inflamed or has a small tear and if you are able to avoid irritating activities temporarily, the tendon can heal without surgery. If a significant tear is involved, surgical repair may be required.
Rotator cuff repair is typically performed arthroscopically on an outpatient basis. During surgery, the surgeon will use sutures to re-attach the injured tendon to the bone. Dr. Ahn will have the patient use a sling full time and avoid active motion at the repaired shoulder for the first 6 weeks after surgery. This is because moving the shoulder actively before the tendon has had time to heal could result in a recurrent tear. Physical or occupational therapy will begin with passive range of motion exercises that address the stiffness that occurs with use of the sling. After 6 weeks, the patient is guided through a progression of exercises from active motion to light strengthening, and eventually to full strengthening as we progress through Dr. Ahn’s post-operative rehab protocol. Patients are typically ready for discharge from therapy and return to regular activity at about 18 weeks after surgery, but this time frame could be extended depending on severity of the injury or by the type of work the patient is returning to. Those who are able to perform their work duties one-handed may be allowed to return to work sooner while still attending therapy.