Rotator Cuff Injuries & Solutions in Kirkland, WA
Dr. Clinton is a fellowship- trained board certified orthopedic surgeon specializing in sports medicine and arthroscopy of the shoulder. She takes pride in making sure that her patients understand their treatment options and takes the time to answer any questions. Call (425) 823-4000 to schedule an appointment today!
The rotator cuff is made up of four tendons (subscapularis, supraspinatus, infraspinatus, and teres minor) that work to hold the humeral head in the socket so that other larger muscles can move the shoulder. Due to high volume daily use, rotator cuff injuries are very common.
Much of the movement that our arms make is determined by the rotator cuff, which is why injuries to this area can be particularly painful. Even a task as simple as lifting your arm above your head would be impossible with a torn rotator cuff.
Rotator Cuff Tear
A torn rotator cuff is a fairly common injury, as well as a painful one. These tears can occur as either a partial, or total tear, which may or may not require surgical treatment depending upon the severity of the individual case. When the rotator cuff is torn, weakness and pain can occur. Over time, especially with a large rotator cuff tear that is not repaired, a certain type of arthritis can occur. The rotator cuff can cause pain without being torn due to tendonitis, bursitis/impingement or calcific tendonitis.
Rotator Cuff Tear Symptoms
Some people that suffer a rotator cuff tear will not experience any pain, but this is not often the case. Typically, individuals will notice symptoms that gradually worsen over the course of a few days or weeks.
At first, the pain will likely radiate from the front of the shoulder before spreading down the arm. This pain will become more intense when the arm is lifted or lowered and may even begin to disrupt your sleep.
In cases of more severe injury, the pain will be immediate. It will also be instantly difficult for the person to move their shoulder joint in any way as there is no longer anything holding the shoulder muscles to the bone.
Potential Causes of Rotator Cuff Tear
Rotator cuff tears are most commonly caused by:
- Repetitive motions
- Multiple injuries to the rotator cuff
- Heavy lifting
- Falling onto the arm or shoulder
- Athletic activities, especially those involving lots of shoulder movement like tennis or baseball
- Shoulder impingement syndrome
Rotator Cuff Repair Surgery
The goal of rotator cuff repair is to improve pain, function, and mobility. We treat rotator cuff injuries arthroscopically, which allows for a quicker recovery and less postoperative pain. During surgery, a camera is placed through a small incision. Through additional small incisions, instruments are placed that allow us to place stitches through the rotator cuff and tie it back down to the bone. Patients are in a sling for 6 weeks following surgery. Strengthening is usually started 3 months after surgery.
Shoulder impingement occurs when bone spurs rub on the rotator cuff. Pain occurs when the arm is in the overhead position. Shoulder impingement may also contribute to the rotator cuff tearing over time.
Many patients with impingement can be treated nonoperatively with activity modification, exercises, physical therapy, anti-inflammatory medicines, and/or steroid injections.
If these measures are not successful then patients may be candidates for arthroscopic surgery. During this surgery, through small incisions, a camera is placed and the bone spurs can be shaved down. This is done as an outpatient surgery. Patients usually wear a sling for 2-3 weeks following surgery. They then work with physical therapy on regaining motion and strength
Calcific tendonitis occurs when calcium deposits are present within the rotator cuff. This can cause severe shoulder pain. This can be treated with cortisone injections and/or breaking up the calcium with a needle. If those treatments don’t work, surgery is an option. Surgery involves arthroscopic removal of the calcium and usually, repair of the area of tendon that the calcium was removed from.
Post-operative rehabilitation and recovery is very similar to that of a rotator cuff repair.