May 6, 2019
By: Dr. Michael O’Malley
The rotator cuff is the name for the group of muscles and tendons that provide strength, support, and motion of the shoulder. Injury can occur to one or more of these tendons, causing a tear. This is a very common cause of shoulder pain in middle-aged and older individuals. Symptoms typically include severe pain and weakness of the arm. A cracking or popping sensation during motion is also commonly described. This can result in stiffness, swelling, and loss of motion resulting in significant debilitation in activities of daily living, as well as work and sport related activities.
An MRI is typically obtained to not only confirm the diagnosis, but to assess the extent of the injury as well. Treatment often begin with conservative measures including rest, ice, activity modification, over the counter nonsteroidal anti-inflammatories, physical therapy, and injection therapies. If these fail to restore pain and function, surgery is considered.
Arthroscopic rotator cuff repair is a minimally invasive surgery performed through tiny incisions, utilizing an arthroscope for visualization. This allows the surgeon to provide a thorough assessment of all the intra-articular structures of the shoulder, including the rotator cuff. The repair typically entails placement of heavy strength suture that passes through the tissue and is secured to bone by way of metal or highly synthetic plastic anchors. Arthroscopic repair is an outpatient procedure that offers many advantages including less pain, faster healing, less scar tissue formation, earlier mobilization, and cosmetically smaller incisions.
Postoperative recovery typically involves the use of a sling for a short time, followed by a progression from passive to active range of motion, as guided by out physical therapy team. Strengthening typically begins around the three month time point, with a full return to activity without restriction between 4-6 months.