Fixing a Rotator Cuff Tear

Rotator cuff tears are common occurrences that often happen later in life. For those with this injury, even the simplest tasks can seem daunting and painful.

Fortunately, there are ways to prevent a rotator cuff tear.  Many orthopedic surgeons recommend one or all of the following prevention techniques: regular exercise; resting after using repetitive arm and shoulder motions; and applying cold or heat packs to reduce shoulder pain or inflammation. However, if you are unable to prevent a rotator cuff tear, there are many things you and your orthopedic surgeon need to consider before determining the form of treatment that will best treat your injury.

The decision on how to treat rotator cuff tears is based on the patient’s severity of symptoms, functional requirements and presence of other illnesses that may complicate treatment. At first your physician might recommend a nonsurgical treatment approach, which may include activity modification (avoidance of activities that cause symptoms), anti-inflammatory medications and physical therapy. 

Research shows that 50 percent of patients who use nonsurgical treatment options will receive relief from pain and discomfort.  However, the other 50 percent will need to consult with their orthopedic surgeon to determine if their injury requires surgery. Following are a few things to consider when making that decision:

• Degree of Symptoms – Patients with minimal symptoms may choose to delay surgery in an effort to achieve success with nonsurgical treatment options. On the other hand, patients who have more constant pain, difficulty with simple activities (e.g., getting dressed, lifting household objects), or pain at night interfering with sleep may opt to have surgery immediately.

• Requirement & Expectations – Some patients might not need rotator cuff surgery if their symptoms don’t interfere with their usual activities. On the other hand, athletic patients who injure their shoulder may choose surgery in order to return to their sport of choice.

• Type of Tear – Smaller tears can be monitored to determine if nonsurgical treatments can help alleviate symptoms. On the flip side, larger tears could benefit from earlier surgical intervention. Large tears can retract (leading to a permanently shortened tendon), and the muscle may irreversibly weaken, making it more difficult to delay repair. In patients with these tears, early surgery might help increase the likelihood of a successful recovery.

• Age of the Patient – Rotator cuff tears in people less than forty are rare but they do occur, and generally require surgery.  Rotator cuff tears will not heal without assistance and evidence shows that tears will likely increase in size as time goes by.  Admittedly, orthopedic surgeons do not know when this will occur, so those patients that have higher physical demands will likely need surgical intervention to repair a tear.

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