Orthopaedic Treatment FAQ

Rotator cuff tears are one of the most common causes of shoulder pain in middle-aged and older people. They can:

• happen suddenly because of a traumatic fall or fracture or from lifting heavy things awkwardly

• develop over time due to repetitive overhead lifting, decreased blood flow to your shoulder, or the abrasive impact of bone spurs

If your job or sport includes lots of overhead lifting, you may be particularly prone to rotator cuff tears.

Not necessarily. Your treatment options are determined by the severity and duration of the problem. Non-surgical treats include rest, wearing a sling, injecting cortisone and an analgesic to reduce inflammation and manage pain, and physiotherapy.

Surgical treatments include

• Arthroscopic rotator cuff repair via a small keyhole incision. This minimally invasive procedure usually involves an overnight stay in hospital. Most patients recover fully in around six to nine months.

• Reverse total shoulder replacement, a form of open surgery to repair massive or irreparable tears. Patients needing this type of operation often have arthritis as well as a rotator cuff tear.

• Arthroscopy and debridement (essentially a clean-up operation).

• Muscle transfers for an irreparable rotator cuff tear.

Based on a diagnosis informed by physical examination, X-rays, and magnetic resonance imaging (MRI), I'll advise you on your most appropriate treatment options.

Where surgery is not contraindicated, I would consider surgical options for acute tears that threaten the health of otherwise strong tendons or chronic tears that don't respond to non-surgical treatment.

An untreated rotator cuff tear can become very painful. It can also undermine shoulder strength and mobility and significantly restrict your activities. If the tear needs surgical repair, you'll need to weigh up the pros and cons of having an operation.

Stiffness and reduced mobility after rotator cuff repair can happen where your body reacts to the surgery by producing scar tissue. When this happens, we recommend treating post-operative stiffness with physiotherapy and injections.

Lots of things will influence the speed of your recovery. Besides the complexity of your tear, age, fitness, and dedication to your rehabilitation program all play a role. After rotator cuff surgery, the average recovery time for resuming most of your daily activities is around six months.

To put this recovery time in perspective, rotator cuff tears happen to muscles and tendons attached to your complex and highly mobile shoulder joint. Repairing them can involve stitching torn tissue back to the bone.

All going well, you'll feel incremental improvements in shoulder strength and mobility for up to two years after your operation.