When Does A Rotator Cuff Injury Require Surgery?

When is Rotator cuff surgery necessary?

You’ve been experiencing a dull ache in your shoulder that doesn’t go away, and now it’s disturbing your sleep. If you’ve been to the doctor and learned that the source of your pain is a rotator cuff injury, you may wonder what the rotator cuff is and whether your injury requires surgery.

The rotator cuff is the cluster of muscles and tendons around your shoulder joint. It can become inflamed, leading to tendonitis. You could also have a small tendon tear, and if you’re in severe pain, you may have a full tear of the tendon.

Dr. Allen Deutsch’s immediate concern is an end to your pain and discomfort. As a board-certified orthopedic surgeon and rotator cuff repair specialist, Dr. Deutsch has the expertise and experience to help you understand your injury and decide if your best option is surgery.

Why rotator cuff injury occurs

Degenerative rotator cuff injury is part of the aging process. If you’re over 40 years old, it’s not uncommon, and more than 50% of those over the age of 80 have tears.

Rotator cuff injury also occurs more frequently in those who use repetitive arm motions. For example, tennis players, baseball players, house painters, and carpenters are more likely to experience this type of injury. Both repetitive arm motion and the effects of aging contribute to many rotator cuff injuries.

On the other hand, anyone can experience a rotator cuff injury from a car accident or a sudden sports accident.

Screening and treatment options

Dr. Deutsch examines you to determine the degree to which the rotator cuff is impairing your range of motion. He takes X-rays, asks you to rate your pain level and asks you to describe situations when the pain intensifies.

If you’re in pain all the time and have trouble with activities of daily living like putting on a shirt or a coat, lifting objects, or sleeping, you likely need an MRI and/or ultrasound. They provide images that show whether you have a partial or a full tear of the tendon in your rotator cuff.

If you have a small partial tear, it may heal with the non-surgical interventions. If you have a full tear or a large partial tear, surgery may be necessary.

If the MRI or ultrasound shows a large tear, you may not want to take a wait-and-see approach. The torn tendon can retract and become shorter, weakening the surrounding muscles. To avoid permanent deterioration of muscles and tendons in the shoulder, Dr. Deutsch may recommend surgery.

If you experience some pain but the impact to your range of motion isn’t too severe, the treatment is usually anti-inflammatory pain relievers, short-term physical therapy, and/or a cortisone shot.

One consideration in the surgery decision is which shoulder has the symptoms. If it’s your non-dominant shoulder and you’re not playing competitive tennis, you may be able to avoid surgery. But if it’s your dominant shoulder and you’re captain of your tennis team, you likely want to be able to resume tennis as soon as you can, so surgery might be the best option.

Whether the treatment is surgery or not, you can expect to be sidelined for a while during the healing process.

If there’s severe trauma from an accident or sudden sports injury, surgery is almost always indicated. But each case is different with many factors to consider.

To go over all of the factors in your situation, call or book an appointment online with Allen Deutsch, MD, for expert treatment for rotator cuff injury and other orthopedic needs.

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