Take a moment to consider the extraordinarily wide range of motion your shoulder joints provide your arms. You can reach around and scratch your back or lift your arms overhead to wave hello. Powering much of this range, while also providing stability, is your rotator cuff. So when a problem arises in the connective tissue, your life is limited in ways you never thought possible, and you want a quick resolution. But is surgery the answer?
At New York Spine and Sports Medicine, Dr. Aron D. Rovner and our team offer a wide range of orthopedic services that help our patients maintain active lifestyles, free from musculoskeletal pain and limitations. As part of our care, we specialize in shoulder problems, with rotator cuff issues at the front and center.
If you’re experiencing rotator cuff problems, here’s a look at when surgery might be your best option.
Behind your rotator cuff
Before we get into the treatments for rotator cuff tears, let’s take a closer look at this area of your shoulder to better understand its role. Your rotator cuff is made up of four muscles that originate in your shoulder blade and come together in the form of tendons to cup the top of your humerus, which is your upper arm bone. These tendons attach directly to your humerus and they provide stability for the ball-and-socket joint that makes up your shoulder.
In addition to literally keeping your shoulder together, your rotator cuff is responsible for any upward motion in your arm, as well as rotation.
When problems arise
Rotator cuff problems generally fall into two categories: Overuse injuries or acute injuries. With overuse injuries, these tendons can break down due to wear and tear. For example, baseball pitchers or painters are among those who routinely suffer from rotator cuff tears thanks to the added stress these activities place on the tendons. That said, anyone can develop a rotator cuff stress injury if the conditions are right.
The second way you can compromise your rotator cuff is with an acute injury that causes a tear in an otherwise healthy rotator cuff. This typically occurs when there’s impact to the area or your arm is wrenched.
The degree of tearing
If you’re experiencing rotator cuff problems, the first order of business is to determine the extent of the damage. To do this, we turn to advanced imaging to take a closer look inside your shoulder.
If Dr. Rovner finds that your tear is on the medium-to-small side, he typically recommends a more conservative approach to the problem. Rotator cuff tears can heal on their own if they’re given enough time and rest, but this requires diligence and patience on your part.
To address the discomfort while you heal, we recommend anti-inflammatory medications and provide corticosteroid injections. We also set you up with physical therapy to help strengthen your shoulder and encourage range of motion.
If, however, Dr. Rovner finds that your tear is fairly large, he may recommend surgery sooner rather than later. Large tears can lead to shortened tendons and weakened muscles if your rotator cuff isn’t promptly repaired.
When conservative measures fail
If we’ve chosen a conservative approach at first, yet your rotator cuff is still giving you problems after 6-12 months, it may be time to turn to a surgical solution to repair the tear. For whatever reason, your body can’t heal the tissue on its own, which means it can use a little outside help.
With today’s minimally invasive surgical techniques, including arthroscopy, Dr. Rovner can often repair your rotator cuff through very small incisions through which he threads a lighted camera and special instruments that translate the movements of his hands in small spaces. This means that your recovery after rotator cuff surgery is greatly reduced compared to if you had open surgery.
To explore your options for a rotator cuff injury, please contact one of our two offices in Garden City, New York, or Fair Lawn, New Jersey.