shoulder

Repair Your Rotator Cuff

Do you have shoulder pain? Looking for advice on Rotator Cuff Repair in San Antonio? Schedule your consultation appointment today at Sports, Occupational and Knee Surgery, San Antonio, Tx with Dr. Peter Holmes, Double Board-Certified in both Orthopedic Surgery and Sports Medicine. He will diagnosis your problem and find the right solutions for you. Go to www.socksrocks.com for more information.

What Is The Rotator Cuff?

The job of the rotator cuff is to keep the ball of the humerus in the center of the shoulder joint, to keep it from dislocating. The rotator cuff consists of four muscles and tendons. Of the four muscles that make up the rotator cuff, the muscle that attaches to the top of the humerus, the supraspinatus, is the most prone to injury as it receives the most stress of the entire cuff. When one of the rotator cuff tendons tears, the tendon no longer is completely attached to the head of the humerus.

What Are The Symptoms Of A Torn Rotator Cuff?

Pain and weakness in your shoulder are the signs you have torn your rotator cuff. The degree of damage dictates the extent of your symptoms. You will have persistent pain, tenderness, weakness, and you won’t be able to move your shoulder through a full range of motion. The most pain will accompany movements such as reaching directly above your head, reaching behind your back, and during lifting motions involving your shoulder. Something as innocuous as combing your hair will become very painful. Over time, you will feel pain even when the shoulder is at rest, particularly when lying on your side in bed.

Acute tears are intensely painful and can be accompanied by a snapping sensation if the tendon has fully ruptured.

How Is A Torn Rotator Cuff Treated?

You may have heard that a torn rotator cuff can heal. This is not true. A strained tendon in the rotator cuff can heal with rest, but once there is a tear in one of the tendons, it will not heal. Still, that doesn’t mean the patient will require surgery. Rotator Cuff Repair in San Antonio, Tx can take many avenues. Dr. Peter Holmes at Sports, Occupational, and Knee Surgery exhausts all conservative options first.

Some patients may want to avoid surgery, so the goal will be to improve function and relieve pain. The problem is that the shoulder will not strengthen, and it is possible to turn a minor tear into a significant tear through continued use. This is typical if the patient, for instance, continues to play the sport or perform the repetitive motions that created the minor tear in the cuff.

Some patients, particularly older patients, are not interested in surgery, so these are possible treatments we may pursue at Sports Occupational and Knee Surgery:

  • Rest – This includes limiting any overhead activities and not raising your arm above your shoulder. If serving and spiking the ball when playing volleyball is your problem, you’ll have to stop playing. Same with swimming or playing baseball or softball.
  • Non-Steroidal Anti-Inflammatory Medicine – Ibuprofen and naproxen reduce pain and swelling.
  • Strengthening Exercises And Physical Therapy – Strengthening the muscles that support the shoulder can restore movement and help with flexibility.
  • Steroid Injections – Cortisone injections are effective anti-inflammatory medicine and will eliminate pain, but there is some thought they may also weaken the tendons. This is not a long-term solution.

How will I know if I need rotator cuff surgery?

If your pain does not improve with other treatments, your doctor may suggest surgery, but the choice for surgery is usually not so cut and dry. Sure, if there is a full tear as a result of a shoulder dislocation or other trauma, you’ll need surgery. But in other cases, there is a lot of grey area in the decision. If the conservative treatments above don’t seem to be having an effect and you’re dealing with pain when sleeping and doing routine tasks, it could be time to consider surgery with Dr. Holmes and our Sports Occupational and Knee Surgery team. Or, if your livelihood is at stake — if you’re a carpenter, for instance — you’ll need surgery to rebuild the strength you need in your shoulder.

These would be situations where we would likely recommend surgery:

  • You have a large tear (over 3 mm)
  • Your tear was caused by an acute injury
  • You have a significant amount of weakness
  • You have lost function in areas where you cannot tolerate it
  • You have had significant pain for over six months

The two different types of surgery that we have available are Arthroscopic Surgery, the most common procedure for rotator cuff repair, and Open Surgery, which is only used in certain cases.

After Rotator Cuff Repair in San Antonio, you may go home that day or stay a night in the hospital. As your shoulder begins to heal, rehabilitation follows either treatment option.

How Do I Prepare For This Surgery?

There aren’t really any physical preparations for rotator cuff surgery with Dr. Holmes, but planning for your recovery is key. As with any surgery, you’ll need to stop taking medications such as blood thinners and NSAIDs two weeks prior, and if you smoke, you’ll need to stop for at least two weeks prior to and afterward to facilitate healing.

But planning for recovery is really what you need to focus on. Here are some tips:

      • Get Help — This isn’t the time to be the lone ranger. You won’t be able to drive for a few weeks, and you’ll won’t be able to do anything with your repaired shoulder, so you’ll need help around the house.
        Think about your shirts — You won’t be able to wear anything that pulls over your head, so think loose-fitting shirts that button or zip.
      • Easy Cooking — Stock up on some easy to prepare meals, whether pre-made fresh or frozen. And bring utensils, pots, and dishes down to the counter. You won’t be able to reach up with your repaired arm.
      • Consider The Shower — You may want to get a detachable showerhead or a shower chair.
      • Pillows For Support — Bring extra pillows to your recovery/lounging area to support your shoulder when sitting or lying down.

    What Will My Recovery From Rotator Cuff Surgery Entail?

    Your recovery will be dictated to a degree by which method was used for your surgery. Regardless of the method, Dr. Holmes uses, however, this is not a simple, quick recovery. Our entire team at Sports Occupational and Knee Surgery is with you through this entire process to ensure your best final outcome.

    Although Dr. Holmes tries to use arthroscopic methods if, at all possible, some cases require the open method, if you’ve had open surgery, you’ll likely spend at least one night in the hospital.

    Once home, there are no shortcuts here if you want a successful end result. Your dedication to rehabilitation will directly impact your return of motion and function in your repaired shoulder. Your rehabilitation will involve three steps:

    1. Immobilization — This first phase is meant to protect your surgically repaired tendon. You will wear a sling to keep your arm from moving, and will not be able to use it. The length of this phase depends on the severity of your tear but will last from 4 to 6 weeks. It’s important to respect the injury and repair and not to place any stress on the shoulder during this time.

    2. Passive Exercise — A physical therapist will help with this second phase, the goal being to strengthen the surrounding muscles and improve range of motion. This will begin sometime within the first 4 to 6 weeks after surgery. The therapist will generally support your arm, moving it in the desired directions.

    3. Active Exercise — After 4 to 6 weeks, you will begin active exercises under the guidance of a therapist. Then at 8 to 12 weeks, you will shift to strengthening exercises.

    Full recovery can take up to one year, with adequate strength and function coming somewhere between 4 to 6 months after surgery. It is important not to rush things with your recovery.

    Schedule A Consultation

    Dr. Peter Holmes and his professional staff at Sports, Occupational and Knee Surgery in San Antonio, TX, will help guide you towards the best treatment for you and will follow you through to full recovery. Call (210) 696-9000 today for a rotator cuff repair consultation at either our San Antonio or Schertz location.