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Rotator Cuff
Dr. William Grant, MD - Albemarle Orthopaedics - Charlottesville, NC

The shoulder is a complex piece of anatomy, allowing us to move our arms and hands in many directions and helping with most daily activities, from combing our hair to lifting our groceries. The rotator cuff is a group of muscles and tendons surrounding the shoulder joint, and healthy rotator cuff tendons are key to ensuring a healthy shoulder joint.

When an injury occurs to the rotator cuff, it can feel like a dull pain deep within your shoulder, making your arm feel more weak and making it harder to perform basic tasks, like reaching your arm up or reaching back. Many patients experience disrupted sleep due to problems associated with their rotator cuffs.

Albemarle Orthopaedics has been helping patients relieve shoulder pain for many years, using state-of-the-art technology and diagnostics to ensure the treatment process is as comfortable, efficient, and effective as possible. If you’re experiencing shoulder pain, rotator cuff wear, or a rotator cuff tear, call our office. We’ll have you back in action as soon as possible and be right by your side every step of the way.

Common Questions about Rotator Cuff

How does a rotator cuff get injured?

Rotator cuff injuries can occur from an acute episode, such as falling on the shoulder during a sporting game. More commonly, however, Dr. Grant sees rotator cuff injuries develop gradually over time—within a period of months to years. This can occur from a problem called impingement syndrome, which occurs when the rotator cuff tendons rub and pinch between the acromion, or the tip of the shoulder blade, and the ball of the shoulder.

Some people have a bony prominence underneath their acromion, causing pinching between rotator cuff tendons and bursa, which is a sac of tissue that cuts down on the friction between all the moving parts of the shoulder during normal activities.

Over time, this can cause inflammation, and patients may develop bursitis (inflammation of the bursa) or tendonitis (inflammation of the tendons) in their shoulder. If this is left too long without treatment, the wear on the rotator cuff may develop into a partial erosion of the tendon or a complete tear, which is much more painful and can take many months to fully recover.

To learn more about impingement syndrome, see our patient education guide.

What does a rotator cuff injury feel like?

While a tendon can tear in a fall, in the same way a bone can break, most patients notice gradual wear in their rotator cuff because they can’t roll over in bed, or their shoulder is stiff in the mornings after a night of sleep. This will also manifest as weakness in the arm. Patients with a partial rotator cuff tear may still be able to move their arm in a full range of motion, but it will be painful. Patients with a full rotator cuff tear, though, will be unable to move in a full range of motion, and they will experience heightened pain.

When should an injured rotator cuff be treated?

Dr. Grant recommends that any patient experiencing chronic shoulder pain come in for a consultation sooner rather than later. The longer impingement syndrome is left without treatment, the longer the recovery time will be. The rotator cuff tendons will continue to wear down from continued use and will eventually break through in the form of a complete tear.

How is a rotator cuff treated?

If caught early enough, Dr. Grant can prescribe conservative, nonsurgical treatment to reduce inflammation and strengthen the muscles, such as physical therapy and cortisone injections. Cortisone injections are used to suppress inflammation at the joint and are typically not uncomfortable for patients.

If a patient still experiences discomfort after cortisone injections and physical therapy, Dr. Grant will have them get an MRI in order to see the soft tissues of the shoulder that do not show up in an x-ray. Based on the results of the MRI—showing whether or not impingement or tearing is occurring—a physical examination, and a conversation with the patient, Dr. Grant will determine whether or not surgery is necessary.

When is rotator cuff surgery needed?

Patients with impingement syndrome that has already caused extensive damage to the rotator cuff (eventually leading to a full tear) and patients who already have a rotator cuff tear may need to get rotator cuff surgery.

For those patients without a complete rotator cuff tear but with a tendon that’s worn down by more than 50 percent, a partial surgery can help resolve the problem and relieve pain. During this surgery, Dr. Grant will remove the bone spur or bony prominence that is causing impingement, making more room for tendons to move. This surgery is completed arthroscopically, meaning it is a minimally invasive surgery using very small incisions. This partial rotator cuff surgery is intended to heal the tendon before it tears all the way through, avoiding the need for a full repair.

For patients with a full rotator cuff tear, surgery is still done arthroscopically. Dr. Grant will place very small suture anchors into the bone and the torn parts of the rotator cuff, bringing the two parts together to heal.

To learn more about rotator cuff tears, see our patient education guide.

How long will the rotator cuff take to heal?

Every patient’s body is different, will have varying degrees of damage, and will react differently to the treatment presented, so it is impossible to guarantee a certain recovery time for rotator cuff tears.

For partial rotator cuff surgery, which requires no stitches, you are expected to be in a sling for less than one week. Physical therapy will be prescribed, and full rehabilitation is expected within four to six weeks.

For full rotator cuff surgery, the recovering tendon will need to be protected in a special sling for about six weeks while it heals back to the bone, and rehabilitation with physical therapy is expected for another six to ten weeks.

Will a rotator cuff heal on its own?

No, impingement syndrome is a gradual condition that causes continued damage to the rotator cuff if left untreated. Sometimes, patients won’t notice the condition worsening for many months until a complete tear does occur. Once the rotator cuff is completely torn, recovery time is about double that of a partial repair, so Dr. Grant recommends that anyone experiencing pain in their shoulder come in as soon as possible for a consultation.

What are rotator cuff strengthening exercises?

While the chance of developing impingement syndrome causing a rotator cuff tear will often depend on a patient’s basic anatomy, it’s always recommended to keep the rotator cuff muscles strong in order to control the ball of the shoulder.

Dr. Grant recommends that everyone engage in moderate exercise three to four times per week, with routines that involve shoulder exercises, to keep the muscles strong and to avoid damage as much as possible.

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