My name is Uma Srikumaran. I'm an orthopedic surgeon with Johns Hopkins...
and Howard County General Hospital.
I specialize in shoulder surgery.
The rotator cuff is a set of four muscles and tendons that attach the shoulder blade...
to the proximal part of your arm or the proximal humerus.
It serves to stabilize the shoulder and socket...
and also helps lift and rotate your arm.
Common injuries to the rotator cuff include inflammation of the tendon itself....
or the surrounding tissue, called rotator cuff tendonitis or subacromial bursitis...
or more significant injuries such as tears.
These tears can be small or partial in size...
or they can involve the entire tendon's full thickness and be quite large.
They occur because of wear & tear
as we age or from acute traumatic injuries.
Treatment for rotator cuff tears can involve simple measures such as rest
and activity modification to avoiding activities that are painful for your shoulder
....to things like physical therapy and icing your shoulder and...
pain medications such as anti-inflammatory medications like ibuprofen and aspirin.
Surgery is a good option for treatment of rotator cuff tears when non-surgical
measures such as physical therapy and pain medications have failed to provide...
symptomatic relief over a period of time.
Other reasons for surgery include a large tear....
or tears that are resulted from an acute traumatic injury.
Finally, if you have a high...
demand occupation that requires a lot of overhead shoulder activity, this may be
another reason to consider surgical fixation.
So, the surgery is typically performed arthroscopically although an open incision
may be needed in rare cases.
The arthroscopic approach uses small incisions around your shoulder to insert
a camera and arthroscopic equipment to perform the work. The goals of surgery are to
remove inflammation, remove diseased portions of the rotator cuff and repair
the rotator cuff tendon back into bone.
Recovery after surgery can be lengthy and can progress over several months.
Typically the patient will be in a sling for four to six weeks after surgery and
physical therapy will begin two to four weeks after surgery and continue over
several months.
Physical therapy is usually individualized and prescribed by the
surgeon after the surgery is performed.
In general, however, the patient starts with
passive range of motion exercises where motion is generated by the therapist and
later towards active range of motion where the patient performs the range of
motion exercises.
After range of motion has returned, strengthening exercises can begin.
The prognosis for rotator cuff repairs is excellent, particularly in terms of pain relief.
Functional results can continue to improve even out to one year.
The majority of patients will return to a high portion of their activities within four to six
months including sports.