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Rotator Cuff Tear Treatment - Specialist in Houston, Beaumont, Cypress


Rotator Cuff Tear

The rotator cuff is a group of tendons in the shoulder joint providing support and enabling a wider range of motion. Major injury to these tendons may result in a tear of these tendons, and the condition is called rotator cuff tear. It is one of the most common causes of shoulder pain in middle-aged adults and older individuals.

Often, the extent of a rotator cuff injury depends on the tendon. It's more difficult for younger people to tear their rotator cuff since the tendon generally has more ability to stretch. If they do, it's usually a partial thickness tear that only extends through part of the tendon. Older individuals are at a higher risk of a full thickness tear that impacts the whole tendon. This is because older individuals often have tendons that may have been injured or stressed before and aren't quite as flexible.

Torn Rotator Cuff Causes

Rotator cuff tears result from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted. It may occur with repeated use of the arm for overhead activities while playing sports or during motor accidents. Most people suffer rotator cuff tears from either injury or degeneration. For example, falling on your outstretched arm can tear the cuff no matter how old you are. Degenerative tears are the result of the tendons breaking down over time and are most likely to occur in older individuals.

Repetitive stress on your arm such as continually throwing a baseball can predispose you to a tear. A lack of blood supply and bone spurs can also lead to rotator cuff issues. Tendons can weaken from repeated use of a steroid injection such as cortisone and smoking. Once they weaken, it's more likely that repeated stress on a tendon from working, playing a sport or exercising will result in a rotator cuff that needs repairing.

Symptoms of a Torn Rotator Cuff

Rotator cuff tears cause severe pain, weakness of the arm and a crackling sensation on moving the shoulder in certain positions. There may be stiffness, swelling, loss of movements and tenderness in the front of the shoulder. The first sign of a tear is usually weakness, pain and immobility in the shoulder. Sometimes you can have trouble sleeping on the shoulder where the rotator cuff tore. Symptoms often vary based on how fast the tear occurs. Instant tears often lead to intense pain, while degenerative tears can take longer for symptoms to develop.

Torn Rotator Cuff Diagnosis

Your surgeon diagnoses a rotator cuff tear based on the physical examination, X-rays, and imaging studies, such as MRI. Rotator cuff tears are best viewed on magnetic resonance imaging (MRI). An ultrasound or arthrography, using dye to see the cuff on X-rays, are also ways to diagnose a torn rotator cuff. While surgical treatment is usually recommended, some can manage the pain through physical therapy and if they already lead a more sedentary lifestyle.

Here are some ways to treat a torn rotator cuff without surgery:

  • Rest
  • Shoulder sling
  • Pain medication injection consisting of a steroid (cortisone) and a local anesthetic in the subacromial space of the affected shoulder to help decrease inflammation and pain
  • Specific exercises

Arthroscopic Rotator Cuff Surgery

Rotator cuff repair may be performed by open surgery or an arthroscopic procedure. In an arthroscopy procedure, space for the rotator cuff tendons will be increased, and the cuff tear is repaired using suture anchors. These anchor sutures help in attaching the tendons to the shoulder bone. Following the surgery, you may be advised to practice motion and strengthening exercises.

Arthroscopic rotator cuff surgery has many benefits. When you combine it with physical therapy, many people can gain more function in their shoulder. Plus, it can lead to quicker mobilization and less scarring than open surgery. Faster healing time, less pain and a lower infection rate are just some of the other perks to arthroscopic rotator cuff surgery.

Rotator Cuff Repair Recovery

After the surgery, it's essential to wear your sling at all times even when you're sleeping. Icing your shoulder at least three times a day for 20 minutes at a time can also reduce the swelling and provide pain relief. Your surgeon will give you prescriptions such as Enteric Coated Aspirin, Norco and Robaxin to help with the pain. It's important to keep up with physical therapy, but not too quickly. The first week after surgery you'll work on hand, wrist and elbow motion.

It can take a while to recover from arthroscopic rotator cuff surgery fully, and even longer for an open surgery. You can typically resume your normal activities by nine months after surgery, and some activities, you can resume sooner than that. For example, you can golf — chipping and putting only — at eight weeks, ski and play sports at four to six months and throw at six to nine months.

Contact Us Today

You don't have to live with a torn rotator cuff. If you're in Houston, Beaumont or Cypress, call us or schedule an appointment today with Dr. Gombera, a rotator cuff specialist. Let us treat your pain and get you back to truly living.



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American Academy of Orthopaedic Surgeons The American Orthopaedic Society for Sports Medicine Arthroscopy Association of North America american shoulder and elbow society international society for hip arthroscopy