Rotator Cuff Tears Could be The Reason for Your Shoulder Pain
By Dr. Arturo Villarreal, Orthopedic Surgeon
When it comes to your shoulder pain, you might be suffering from a rotator cuff tear. Your shoulder joint contains tendons that connect the bones to the muscles. Rotator cuff tears are caused by torn tendons in the shoulder joint.
Orthopedic surgeons can treat joint pain in your shoulders, elbows, wrists, hands, hips, knees, ankles, and feet. If you’re experiencing pain in any of these critical areas, Advanced Pain Care Orthopedics can treat it.
Is My Shoulder Pain a Rotator Cuff Tear?
There are two common types of rotator cuff tears — acute traumatic and degenerative.
An acute traumatic tear can be caused by any sort of trauma to the shoulder, such as a car accident. Or maybe you’re a weekend warrior who is trying to stay active — doing a high-impact activity can lead to a traumatic tear. We typically see these tears in folks who are 40 years old or older.
A degenerative rotator cuff tear occurs with wear and tear as you age over time. Some studies show that even people without shoulder pain who are over the age of 60 can still have a degenerative-type rotator cuff tear.
If you have a large tear that causes the shoulder to not function properly or it’s hard to lift your shoulder, that can be an obvious sign that something is wrong.
But, it’s also possible to tear your rotator cuff and not realize it.
You might have pain that you attribute to a nagging injury — maybe you lifted something incorrectly or slept funny. You might ignore it for a while before you finally seek a medical professional’s opinion.
Do I Need Immediate Care if I’ve Injured my Shoulder?
If you have a rotator cuff tear — acute or degenerative — it’s much better to be proactive about your treatment rather than delay it.
If you think you might have an acute tear, we find that earlier treatment can lead to better outcomes.
In the case of degenerative tears, you might end up with shoulder arthritis if you delay treatment. At that point, we can’t repair the rotator cuff anymore and we have to do a shoulder replacement. That’s a more involved surgery.
How Does APC Assess My Shoulder Pain?
We start with the basic principles of medicine. That means we take your medical history and perform a physical examination. We’ll also take some x-rays so we can make sure there’s nothing else going on in the shoulder. All of this is done at your first appointment.
If you have had shoulder pain for quite some time and then also show you have weakness during the physical exam, I’ll be a little bit more concerned about a rotator cuff tear. And in those instances, I may send you to an imaging facility to get an MRI to confirm that.
But if it’s just shoulder pain and there’s low suspicion for a rotator cuff tear, we may be able to address things in that first visit without an MRI.
What Are APC’s Rotator Cuff Tear Treatment Options?
Your treatment plan will depend on your tear. Surgery is not always required — in fact we offer a variety of non-surgical treatments.
Non-surgical care options are appropriate for degenerative tears if you don’t have associated arthritis in the shoulder and haven’t been in pain for a long period of time. In that setting, you may do very well with conservative care and without surgery.
If you have a degenerative rotator cuff tear, we may explore these treatments a little bit more extensively.
Your options might include a combination of:
- Activity modification — avoiding activities that cause pain in the shoulder for a short period of time
- Medications — they often include anti-inflammatory medications
- Physical therapy — attending multiple sessions to help strengthen the shoulder
- Injections — a corticosteroid injection into the shoulder is a common option
If you’re someone who is younger — in the 40-to-50-year-old range — who had an acute tear after a fall or a car accident, then we may talk more about surgical repair.
If the sound of surgery scares you, you should know that almost all of my rotator cuff repairs are done arthroscopically.
That means it’s a minimally invasive procedure. A small incision is created to feed an arthroscope into your shoulder.
From there the type of repair, the type of anchors used, and the number of anchors used will often depend on the particular tear pattern, tear size, and tear characteristics. But it’s still going to be done through small incisions with the arthroscope.
If I Need Surgery, What’s the Recovery Process Like?
Your recovery time frame is going to depend on the tear size and tear characteristics that we see in the surgery.
For very large tears, we’re especially focused on making sure the rotator cuff successfully heals, and so in that setting, the return to full activities may take a little bit longer.
You can expect to be in a sling for anywhere between four to eight weeks. Depending on the tear size and characteristics, you might need to wait four to six months before you can return to full, unrestricted activities.
The good news is that most patients only need about 10 days’ worth of pain medication following surgery. After those 10 days, you’re often able to transition to non-narcotic type pain medicines such as Tylenol.
During the whole recovery process, you will also spend time with a physical therapist to work on exercising and moving the shoulder again.
Can You Describe a Recent Rotator Cuff Tear Recovery?
A few months ago a gentleman in his 40’s dislocated his shoulder at work — it was a big injury.
He actually ended up breaking a piece of his glenoid off. He tore some of his shoulder labrum, tore his biceps, and tore his rotator cuff all in the same setting.
So not only did he have a rotator cuff tear, but — because he had broken the socket portion of his ball-and-socket joint in the shoulder — his shoulder kept feeling like it was going to dislocate.
That surgery was done all through the arthroscope — but it involved repairing his labrum, putting his broken bone back in place, and repairing that with anchors. It also involved repairing his rotator cuffs as well.
After surgery, his recovery was largely a rehab-driven process.
Luckily, he did not need pain medicine for very long. I think that has a lot to do with our pain physicians at APC.
They will give you peripheral nerve blocks prior to your surgery. That way when you wake up, you have less pain, which is very helpful with post-surgery pain management.
His full recovery process lasted about six months, and he is now fully rehabilitated. He has great strength, no further feelings of shoulder dislocation, and he is back at work.
What Makes APC Orthopedics Unique?
As someone who grew up in Austin and attended medical school in Texas, I’ve had opportunities to visit Texas practices to see how they work. I joined APC because it’s a unique opportunity to mold orthopedics with pain management and neurosurgery offerings.
We have a large team that supports you throughout your entire pain treatment journey.
Our surgery center is in the same building as the pain clinic, which makes it easy for you to get comfortable with visiting one facility.
We have a referral department that takes care of getting your MRIs and physical therapy arranged.
And we have a great team in the orthopedic department who can address any questions that may arise during your whole recovery process.
If you have any questions regarding rotator cuff tears or our multidisciplinary approach to pain management, contact us through our live chat or book an appointment with one of our specialists.
Keep Reading: What to Expect at a Pain Management Clinic