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Do I Need a Rotator Cuff Repair?

Rotator Cuff Repair Symptoms

Symptoms from a rotator cuff are due to the inflammation from the strain, which causes swelling, leading to localized pain and decreased mobility. Since the rotator cuff is hidden well below, the swelling is not so easily felt. However, the swelling is enough to fill up the already small space that exists in the shoulder joints to reduce mobility of the shoulder and shoots pain with movement.

The following symptoms that may be felt with a rotator cuff tear:

  • Numbness in shoulder
  • Pain when lying on shoulder
  • Decreased mobility in shoulder
  • Arm weakness
  • Inability to lift arm high due to pain
  • Decreased mobility in the arm
  • Inability to lift things as one normally does
  • Clicking and popping in arm movements

RISKS

The following are risk factors that increase the chances of a rotator cuff development:

  1. Age

Most causes for rotator cuffs are degeneration rather than injury. This means that it usually develops over a long period of time due to normal wear and tear. It is most common for people at the age of 40.

  1. Work related strain

Jobs and sports that involve repetitive arm motion such as baseball pitchers have a higher risk of developing a rotator cuff. When constant lifting and overhead motion is involved, people are more prone to overuse tears

  1. Genetics

If a family is involved with a medical history in rotators cuffs, then the risk is higher. There may be a genetic explanation as to rotator cuff injuries occurring more in certain families.

PREVENTION

Rotator cuff tears are more common as one grows older. However, the chances increase with other risk factors such as sports activity or jobs activities that involve repetitive overhead motions that contribute to the constant wear and tear in the rotator cuff. The following are examples of prevention methods that can be done to prevent the development of a rotating cuff tear:

  • Exercise

Stretching before doing any strenuous activity helps the body warm up. Otherwise, the rotator cuff can easily get inflamed. Strengthening the rotator cuff through low resistance exercises also helps avoid this injury. These strengthening exercises are essential to provide the shoulder a balanced strength. The key is to keep the shoulder strong and flexible along with the other muscles in the shoulder.

  • Be physically aware

Once soreness is felt in the shoulders after performing a certain activity, don’t simply ignore it. Further exercises or doing other activities might only worsen the condition of a rotator cuff tear. If the conditions continue to worsen, consult a physician immediately.

  • Proper posture and lifting

Most of the time during work, arms are stretched in front of the body. This posture ruins the shoulder balance, which eventually leads to a rotator cuff tear. Some work also requires plenty of lifting, if improperly done can also lead to a rotator cuff tear. Hence, proper lifting techniques must be learned and practiced.

TREATMENT

Conservative Treatment

A rotator cuff is a group of four muscles whose tendons have a covering around the upper arm bone (humerus) and the top of the shoulder that forms sort of like a “cuff”. Together with the joint capsule, ligaments and labrum, it stabilizes the shoulder joint and allows a person to lift and rotate one’s shoulders and arms. Sometimes, either a partial or complete tear can develop in the tendons, which cause excruciating symptoms such as localized pain, numbness, muscle weakness, immobility in shoulders and arms, etc.

However, not all rotator cuff tears need immediate surgery. Where possible, conservative treatments are first administered to patients before a surgery is considered. The following are examples of conservative treatments for rotator cuff tears:

  • Medication

Usually, the medications given are over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). This helps reduce the inflammation that has occurred in the rotator cuff tear to reduce the pain from the symptoms.

Steroid injections administered in the shoulder joint can be recommended to reduce the pain from the symptoms however, they are detrimental to one’s health if used too often. Therefore, they should be used carefully as they can weaken the tendon.

  • Physical Therapy

This is one of the initial treatments that are suggested by the physician. Some exercises can specifically target the location of the rotator cuff injury. This will help improve the flexibility and strength of one’s shoulder. A physical therapy plan must be developed together with a physician to ensure that the exercises performed are correct.

Surgical Treatment

In most cases, conservative treatment is enough to heal the rotator cuff tear. However, in severe conditions a surgery may be required such as a complete tear of the tendon from the bone.

Bankart Repair – A procedure where anchors hold your labrum together

Rotator Cuff Repair – Surgeon uses sutures to repair rotator cuff

Open Repair

This is the more traditional surgery performed to address rotator cuff tears. It is often done as well when the tear is quite large. It involves an incision about seven centimetres long. The incision is made over the shoulder and the surgeon opens a flap in the shoulder muscles to access the torn tendon. The surgeon either reattaches the tendon to the bone or does a tendon transfer.

A tendon transfer is performed when a tendon is severely damaged to be reattached. A tendon from a different location is used to repair the rotator cuff. Usually, the Latissimus dorsi tendon is used. Two incisions are made: on the front of the shoulder and the other at the back. In the back, the surgeon detaches a part of the Latissimus dorsi tendon, attaches a suture (threadlike material used to reattach tendons) then reaches for it through the front incision then secures it in a new position. It is connected to the remaining rotator cuff tendons and bones.

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