Rotator Cuff Tear
For most patients, the initial treatment involves:
- Rest If the tear resulted partly from overuse, resting the shoulder may help.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) Over-the-counter pain medications, such as ibuprofen, are used to ease discomfort by reducing the inflammation around the torn tendon.
- Strengthening and stretching exercises Physical therapy focuses on strengthening the muscles around the rotator cuff. A program can be done at UCSF or at a facility close to home.
- Corticosteroid injections Corticosteroids can reduce pain by decreasing inflammation.
For patients who don't improve enough with nonsurgical treatment, surgery is an option. It also may be the best first option for patients whose injury occurred in a sudden single event, such as a fall or car accident.
A majority of rotator cuff repairs are performed arthroscopically at the UCSF Orthopaedic Institute. (An arthroscope is an endoscope for use in joints.) The surgery involves inserting slender instruments and a tiny camera through several small incisions around the shoulder. "Bone anchors" are then used to reattach the rotator cuff where it belongs. Made of metal, plastic or sutures, the anchors hold the rotator cuff in place while the tissues heal. Patients are under general anesthesia (completely asleep) and given a nerve block (an injection that interrupts pain signals in the area), which lessens post-op pain. The surgery typically takes 60 to 90 minutes.
Sometimes a torn rotator cuff cannot be repaired, yet these patients still have several options, such as shoulder replacement surgery. UCSF is a national leader in research to improve shoulder surgery techniques and in performance of reverse shoulder replacement, which may be the best option for patients with shoulder arthritis as well as a rotator cuff tear.
Recovery from rotator cuff repair is a relatively slow process. Patients are typically in a sling for six weeks to allow the tendon to heal and reattach. During that time, patients shouldn't drive, and their physical therapy regimen is limited to passive range-of-motion exercises, which keep the joint from becoming stiff while protecting the repair.
At week six, the sling is removed, and patients begin doing active range-of-motion exercises without weights. They can also begin jogging and doing other lower body exercises. At week 12, physical therapy starts to focus on strengthening moves, with the program completed around the fourth month post-op. A full return to activities is allowed between five and six months post-op, with the repair considered totally healed at six months.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
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