What is a rotator cuff injury?

The shoulder is a complex joint with many large and small muscles helping to stabilize the joint and allow motion of the arm. The shoulder is the most mobile, but also most inherently unstable joint in the body. As a result, injuries to the shoulder are very common. A common shoulder injury seen in all ages, but particularly in adults, occurs to the rotator cuff tendons. These muscles and their tendon attachments to the humerus bone (the top part of the upper arm), help stabilize the “ball and socket” joint as the larger muscles around the shoulder help move the shoulder in all directions. As we move through life, injuries to the rotator cuff tendons can occur through traumatic means, through repetitive microtraumas from overuse, or simply from degeneration that is a naturally occurring process with age. When this occurs, the shoulder can feel painful with any movement, but particularly with overhead motions of the arm. With rotator cuff injuries, the arm may be difficult to raise or keep raised when stressed with weight. Night pain often accommodates rotator cuff injuries, and radiating pain or numb, tingling sensations can spread down the arm and radiate to the neck. Sometimes patients can remember a moment when they hurt their shoulder and other times, patients cannot recall a specific event, but find that their shoulder has been bothering them for quite some time. Dr. Alexander Brown, orthopedic shoulder specialist, can diagnose and treat patients in Nashville, Tennessee and the surrounding areas who have suffered a rotator cuff injury.

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Rotator Cuff Injury

How do you treat a rotator cuff injury?

Dr. Brown treats rotator cuff injuries in all patient populations and specializes in performing rotator cuff repairs arthroscopically when necessary. With an initial evaluation including a thorough history and detailed physical exam, Dr. Brown will determine if imaging such as x-rays, or more advanced imagining such as MRIs are necessary for further diagnosis. Once a diagnosis of rotator cuff injury is made, non-operative measures are usually the next best step. Many conditions will become less painful with anti-inflammatory medications, rest, and a directed physical therapy program. The use of an injection of steroids may be utilized as well to help calm down inflammation. Often, Dr. Brown will utilize an ultrasound to perform his injections to ensure the precise placement of medication.

If the history, exam, and images reveal that the rotator cuff is torn, non-operative measures can still be utilized to treat this condition in certain circumstances. However, in many situations, surgery is the best option to fully restore function and to eliminate pain. Dr. Brown repairs rotator cuffs using minimally invasive techniques that require a small camera, small instruments, sutures, and anchors. The specific manner in which the tendons are repaired back to the bone is a customized decision that Dr. Brown determines based on the patient. Each case is unique and patients in the greater Nashville area trust Dr. Brown to be the best orthopedic surgeon for their torn rotator cuff.

How long does it take to recover from a rotator cuff surgery?

As with many musculoskeletal injury conditions, recovery time is based on how long it takes for the tendon to heal before stressing it again with the actions of life that could re-tear or re-injure it if performed too early in the healing process. Often patients are in a sling for about 6 weeks and are allowed to do full overhead daily activities around 3 months. Returning to sporting activities is usually allowed around 4 to 6 months depending on the patient’s progress. Physical therapy is an integral part of a good outcome with rotator cuff surgery. Patient’s will attend physical therapy session frequently during the initial weeks after surgery, and then will taper their visits as they become more mobile and stronger. These physical therapy visits will focus on pain and swelling control, getting motion back at the proper time points, and then strengthening the shoulder so it can re-enter the stress of daily life and sports.

For more information on rotator cuff injuries and the treatment options available,  please contact the office of Dr. Brown, serving patients in Nashville, TN and the surrounding communities, at Nashville Sports Medicine and Orthopaedic Center, 615-284-5800.

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