The rotator cuff is vital to shoulder movement and function. When there’s a tear in the rotator cuff, it’s likely to result in discomfort and pain in the shoulder.
Three BayCare Clinic shoulder experts shared those insights during a recent livestreamed discussion on rotator cuff tears and treatment options.
Drs. Carl A. DiRaimondo, Jon Henry and Craig L. Olson, all of Orthopedics & Sports Medicine BayCare Clinic in Manitowoc, participated in the livestream.
“The shoulder itself, there are 18 muscles that originate or attach on the shoulder blade,” DiRaimondo says. “The deepest layer of four muscles are referred to as the rotator cuff complex.”
When the rotator cuff sustains an injury, such as a tear, it’s wise to act sooner than later, Henry says.
“In general, a rotator cuff tear doesn’t heal itself,” he says. “It’ll tend to get worse over time and if it does … patients will have greater symptoms and impairment over time. If it isn’t treated, it can get worse.”
Rotator cuff tears are common.
“Too common,” Olson says. “It’s probably one of the most common things we all see in the office. With the advanced imaging that we have available now, we’re actually seeing better definition of the rotator cuff to understand the nature of the tear or partial tears. It’s extremely common.”
Several options available
Treatment options depend on the severity of the injury, DiRaimondo says. There are nonsurgical options that can help manage a rotator cuff tear and surgical options when simple management is not an option.
“Whether we do or don’t know if there’s a tear, oftentimes we’ll start with a therapy program and medications and maybe an injection to help inflammation in the shoulder,” he says.
Surgery becomes an option when these options aren’t effective.
“The gold standard for a rotator cuff tear is … we’d like to repair it,” DiRaimondo says. “We’d like to reattach the tendon back to bone to restore the normal anatomy. … We do most of this now through small incisions, arthroscopic surgery, outpatient procedures.”
After surgery, it’s important to follow through with physical therapy, Henry says.
“For most patients, it’s 12 to 16 weeks of physical therapy from the time of surgery,” he says.
Patients can expect to make steady post-surgical progress up to one year after their shoulder procedure, Henry says. “The therapy doesn’t stop at three or four months.”