The rotator cuff is a group of tendons and muscles that keep the ball of the upper arm bone securely positioned in the shoulder socket and also facilitates the rotation of the arms. These tendons attach the muscles to the upper arm. When the tendons or muscles develop tears or get inflamed due to the repeated stress injuries or trauma, the affected individual is likely to experience shoulder pain while rotating the arm or performing overhead movements.
The range of motion of the affected arm is also likely to get restricted. Individuals affected by degenerative bone diseases, or those who play sports such as tennis, rowing, golf or swimming are at an increased risk. Shoulder tendonitis or bursitis could be responsible for causing such an injury. Though drug therapy and physical therapy might help provide relief from pain, doctors might recommend a surgery if the symptoms are severe.
Besides a physical examination, doctors often conduct an X-ray examination, if they suspect a torn rotator cuff. Other imaging procedures such as MRI or arthrography might be performed. Surgery will be recommended only if the non invasive procedures are not helping. If the usage of medications, physical therapy, or other methods are unable to fix the problem and the patient is facing difficulty in moving his/her arm overhead, doctors recommend surgery. The cost for this surgery could range between USD 10,000 to USD 20,000.
Another condition that might call for surgery is the development of bone spurs in the shoulder. Shoulder bone spurs are bony outgrowths that develop at the place where tendons meet the bone. These might put pressure on the surrounding bones and nerves, thereby causing inflammation and pain. If the muscles are inflamed and other treatment options are not working, surgery will be performed to treat this condition.
The type of surgery that will be performed will depend on the size of the tear. Doctors could insert an arthroscope to ascertain the extent of damage and carry out arthroscopic rotator cuff repair. An arthroscope is a small instrument that has a tiny video camera, and a light. The camera is connected to a monitoring system. It is inserted into the shoulder through a small incision. The camera is placed in the subacromial space. The doctor can view the cartilage, tendons, and ligaments on the monitor. Other tools are also inserted into the joint through small incisions to repair tears and remove the damaged tissues or bone spurs.
This is called miniature open surgical procedure. In case of big tears, doctors might resort to open surgery, whereby a large incision is made and the shoulder muscle (deltoid) is detached to are made. Once the repairs are carried out, the incision is closed and dressing is applied. The surgery might involve debridement in case of a partial tear. In case of a complete tear, the tendon has to be reattached to the head of humerus (upper arm bone) with sutures and suture anchors. Sutures are attached to the anchors (metal or a material that is dissolvable) that attach the tendon back to the bone.
The recovery time for this surgery will vary, depending on the extent of the damage and the procedure employed. One might take about 6-12 months to completely recover. Precautions must be taken during the rehabilitation period. One has to wear a sling for about 4-6 weeks. During this period, strenuous activities have to be avoided at all costs. The shoulder joint complex must not be stressed. The aim is to regain the strength of the muscles and restore the normal range of motion, but this must be done gradually.
Once the healing process starts, one will learn exercises in the physical therapy sessions. The aim is to help the patient develop a passive range of motion. The patient will need to perform exercises where the shoulder and arms are moved without straining the muscles. Once there is considerable improvement, the physiotherapist will suggest other exercises or stretches that will help in strengthening the muscles. The duration of recovery period might differ depending on how well your body responds to the treatment. Those who follow all the surgery aftercare instructions will recover faster.
If a person has suffered from a rotator cuff injury, doctors may recommend surgery only when the other treatment options have been exhausted. In case of minor tears, immobilization with a sling, along with rest, medication and physical therapy will definitely prove beneficial. Since tears in this part of the shoulder joint can cause severe pain and other distressing symptoms, if you ever end up with a shoulder injury, get yourself medically examined. As with all medical conditions, timely diagnosis and treatment will ensure a speedy recovery.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.