You’ve injured your rotator cuff, and you’re anxious to regain full use of your shoulder and arm, but you’re not too keen on the idea of surgery. Each year in the United States, almost two million people seek medical help for an injured rotator cuff, and 80% of these patients achieve improved function and pain relief nonsurgically.
While William Schell, MD, excels at surgical repairs of the shoulder and rotator cuff, our team of orthopedic experts fully appreciates that not every rotator cuff injury warrants such a step. Here, we explore how (and when) we can try a less aggressive approach toward healing your rotator cuff injury.
A matter of degree
Your rotator cuff is a band of tissue made up of four muscles that come together as tendons. This tough band of tissue is responsible for holding your arm in your shoulder socket, and it also enables you to lift and rotate your arm.
Rotator cuff injuries typically develop for one of two reasons: 1) A traumatic injury that tears the tissue; or 2) Overusing the rotator cuff, which weakens the tissue, leaving it vulnerable to inflammation and tearing. This is why rotator cuff injuries are common among tennis players or baseball pitchers.
When you damage your rotator cuff, our first step is to determine whether there’s a tear and, if so, to what degree.
With degenerative rotator cuff problems, there may be no large tear, but many microtears in the tissue that lead to inflammation. If the problem isn’t addressed properly, you run the risk of tearing the tissue — either partially or completely.
With a partial tear, one of the muscles in your rotator cuff is damaged. With a complete tear, which we also call a full thickness tear, the damage goes through the tendon or the tendon detaches completely from your bone.
Once we figure out the extent of the damage, we can recommend the best path forward for regaining pain-free use of your shoulder and arm.
Treating inflammation and partial tears
If you don’t have a full thickness tear in your rotator cuff, we typically recommend conservative treatments.
For starters, you'll rest your shoulder and curb any activities that rely on your injured shoulder. To help, we may outfit you with a sling to keep your shoulder immobilized and you can ice the area to reduce inflammation.
We also recommend nonsteroidal anti-inflammatory medications to help with the inflammation and discomfort. If these medications don’t do the trick, we can give you a corticosteroid injection, which contains a local anesthetic for the pain and a steroid for the inflammation.
Once you’re comfortable, you embark on a course of physical therapy that’s designed to strengthen your shoulder while preserving range of motion.
If all goes well, you’ll regain use of your shoulder, but it’s important that you practice patience during this time. We know you’re anxious to use your shoulder again, but pushing your rotator cuff too early can lead to larger problems.
When surgery is the best solution
There are times when surgery might present the better road option for rotator cuff injuries. Rotator cuff tears generally don’t heal on their own, and our goal with nonsurgical treatments is to strengthen your shoulder muscles to work around the problem.
If you have a large tear in your rotator cuff and you rely on your shoulder a good deal, you may want to consider a minimally invasive procedure in which Dr. Schell repairs the damaged tissue.
The best way to find out which treatment option is right for you is to schedule an appointment at our New York City office on Columbus Circle on the Upper West Side. To get started, simply click here.