I have a rotator cuff injury: Do I need surgery?
So what is the rotator cuff?
The rotator cuff is a group of four muscles: the infraspinatus, supraspinatus, teres minor, and the subscapularis. One of their main functions is to depress and stabilize the head of the humerus, or in other words, centralize the ball part of the ball and socket joint that makes up the shoulder. This position is crucial to more efficient mechanics of the shoulder.
I have a rotator cuff injury. What kind do I have?
There are many different types of injuries that can involve any of the four rotator cuff muscles. An injury can occur to the tendons that attach these muscles to the bone which may lead to inflammation also known as tendonitis. The muscles themselves can experience a strain just like any other muscle due to overuse, excessive load, or some type of traumatic event. Strains can vary from a grade 1, which is classified as mild, to a grade 3, which is considered severe and involves a tear. When there is a tear, the tears can further be classified as partial vs. full thickness or incomplete vs. complete. When one or more of these situations occur, there may be a loss of function of the shoulder, including decreased range of motion or lack of strength. In many cases it is common to hear more “clicking” as the shoulder moves or to feel increased pain at specific elevations of your arm.
How do I know I have a rotator cuff injury?
If you suspect you have a rotator cuff injury, you should always check with your doctor for a diagnosis and whether the injury needs treatment. Your provider may recommend starting with an x-ray followed by an MRI (magnetic resonance imaging) to determine the type of injury and its severity.
Signs you should go see a doctor for a rotator cuff injury include: shoulder pain that becomes worse, a decrease in range of motion, waking from sleep because of shoulder pain, muscle weakness, or shoulder pain that interferes with your daily activities.
I have a tear, will I need surgery? How do I treat a rotator cuff injury?
The severity of the tear will determine whether or not the doctor will recommend surgery. In many cases, milder or smaller tears can heal with time and an appropriate treatment plan. In the more severe cases of large or complete tears, surgery is more likely to be recommended. In some cases where levels of arthritis and age are high, a shoulder replacement may be appropriate.
Early treatments for a rotator cuff injury usually involve rest and the potential use of nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen to help reduce inflammation and discomfort to the area. In many cases, your doctor might recommend physical therapy which will focus on restoring functionality to the rotator cuff and further protecting it from injury. That could include strengthening muscles that have gotten weak, stretches to improve flexibility and mobility, and other exercises to improve movement mechanics. If symptoms persist, your treating provider may recommend corticosteroid injections to reduce pain and inflammation to further promote the effectiveness of physical therapy.
If you have a rotator cuff injury or even a tear, do not panic. Don’t be afraid to seek licensed medical attention as there are many beneficial exercises that can be learned and performed in the comfort of your home to treat your shoulder and prevent further damage.