Rotator cuff injuries are a common cause of shoulder pain in people of all ages. The diagnosis is usually done by collecting patient detailed history, physical examination and imaging.
The following article provides detailed information about the rotator cuff tear, surgical treatment of rotator cuff injuries, and care after surgery.
Rotator Cuff Tears:
A rotator cuff is a group of tendons that connect the upper shoulder four muscles to the bone. Cuff strength allows the muscles to lift and twist the tendon bones. Tendons run under the acromion (part of the scapula), where they are very vulnerable to damage. It can cause tears and weak and painful shoulders.
Tears can suddenly arise from a traumatic event or develop gradually. When the rotator tendons or muscles tear, the patient can no longer lift or rotate his arms with the same range of motion as before the injury, and experience significant pain associated with shoulder movements. Pain is also very common at night and often spreads in the arms for more information about the rotator cuff injury causes, symptoms, treatment visit.
How Is A Rotator Cuff Tear Diagnosed?
Your physiotherapist or doctor may suspect a rotator cuff tear based on your medical history and the results of a series of clinical tests.
Diagnostic ultrasound scanning is the most accurate way to diagnose the size and position of your rotator cuff tear. MRI can show a rotator cuff tear. X-rays can also help to detect but are of low diagnostic value.
Treatment:
Treatment recommendations range from rehabilitation to surgical repair of one or more torn tendons. The best treatment method is different for each patient.
Rotator Cuff Injury Best Treatment?
Small and medium-sized tears of rotator cuffs are usually successfully treated with conservative treatment. Physiotherapy is often one of the first treatment options offered by your shoulder doctor.
If conservative treatment does not relieve your symptoms or you suffer from bursitis in the shoulder, an injection with corticosteroids may recommend. These injections can relieve your pain during sleep or allow you to fill your rotator cuffs. Corticosteroid injections are known to weaken your tendons potentially. Therefore, prescription injection is the best to use.
Unfortunately, major rotator cuff injuries may require rotator cuff surgery (arthroscopic or open) if physiotherapy treatment does not help. For massive rotator cuff tears, it may be necessary to replace the shoulder or reverse arthroplasty of the shoulder to restore some of the function. Postoperative rehabilitation is required by a physiotherapist to regain your shoulder safely.
Early treatment of rotator cuff tear is essential. Delay will result in pulling out the rotator cuff tendon, making cuff repair or cuff repair surgery more difficult and less successful. The best results in rotator cuff injury will achieve when rotator cuff injuries are fresh.
Nonsurgical Treatment:
- Change activity (avoid activities that cause symptoms).
- Analgesics and anti-inflammatory drugs
- physiotherapy
If all the above nonsurgical treatment fails, then the doctor may suggest surgery depending upon your condition.
Surgical Treatment:
The commonly used surgical techniques for rotator cuff repair are:
- Arthroscopic tendon repair
- Open tendon repair
- Tendon transfer
- Shoulder replacement
- Mini-open repair
Dr Chandra Sekhar is the Best Shoulder Joint surgeon in Hyderabad.
Care After The Rotator Cuff Surgery:
Medications:
Keep a list of the medicines given by the doctor: You need to keep the list about the amount, and when, how and why you take it. Take a file or pill bottle for later visits. Take your emergency medicine list with you. Discard the old drug list. Use vitamins, herbs, or food supplements as directed.
Take the medication as directed: Contact the doctor if you think your medicine will not function as expected. Tell him about possible drug allergies and whether you want to stop taking or changing drugs.
Antibiotics: These drugs used to control or prevent bacterial infections after surgery. Always use your antibiotics exactly as directed by the doctor. Do not stop taking medicine unless directed by a doctor. Never take antibiotic residues that you receive in other diseases.
Medication for Pain: You may need prescription medicines to eliminate pain caused after surgery.
- Learn how to take your medicine. Ask which medication and how much you should consider. Make sure you know when and how often you need to receive it.
- Before taking medication, don’t wait until the pain is severe. Meet the doctor if your pain does not subside.
- Painkillers can make you dizzy or fall asleep. Call someone when you get out of bed or need help.
NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce swelling and pain or fever. This medicine must purchase with a doctor’s prescription. This drug can cause stomach or kidney problems in certain people. Always follow the doctor’s prescription before using this medicine.
Follow up visits:
Ask the doctor for information about where and when to come for follow-up visits. For continuing care, treatments. Ask the doctor when you should return to your stitches taken out.
Care Your Wound:
You can remove the bandage 48 hours after surgery and take a shower if your operation has performed arthroscopically and you don’t have a pain catheter. If you have a pain catheter, it must be removed 72 hours after surgery by a family member along with a shoulder bandage.
If your surgery performed with an open incision, you can take off your dressing five days after the operation. After the bandage removed, you can take a shower.
Sometimes significant bruising is seen on the front of the shoulder or along the biceps muscle. It is normal and is accompanied by mild internal bleeding after surgery. It’s better to keep it dry. If you notice any, swelling, bleeding, or pain that has increased five days after surgery, please contact the doctor. Redness around the incision is very common and should not be a problem unless it is accompanied with drainage five days after surgery, which spreads through the incision or fever.
Diet:
We recommend a light diet on the night of the operation and the following day. However, you can resume a regular diet as soon as you tolerate it.
Quit smoking:
Smoking can slow down the healing procedure after rotator cuff surgery. Ask the doctor how to stop smoking.
Ice your shoulder:
Ask the doctor if you have to put ice or cold packs on your shoulders. This treatment can relieve pain, swelling and muscle spasms.
Use Slings:
You may need to use a sling to for 4 to 6 weeks after surgery. This sling prevents your hands from moving. While sleeping a pillow attached to the sling keeps the hands away from your body. This position reduces pressure on your wound and increases blood flow to the surgical area so that the area can heal.
Physiotherapy:
Your physical therapy can begin immediately after surgery, and the doctor will suggest you the physiotherapist under him. If an exercise causes pain, stiffness or swelling in your shoulder, stop doing it and tell your doctor. First, do exercises that will cure your rotator cuff. Don’t use your hands to lift anything. Don’t use your hands to move, press down while changing or lying down position. After a few weeks, the doctor can offer you treatment at the swimming pool. Water allows you to move your arm with a little pressure on your shoulder.
Over 2 to 3 months, the doctor will add exercises that use your shoulders more often. They begin with activities such as lifting and stretching arms. Only do the exercises that the doctor suggest. Over time, you will do exercises that strengthen your shoulder muscles. After 4 to 6 months, you can start activities such as tennis and other racket sports where you raise your arms above your head. It can take up to one year to repair all your daily activities after the surgery.
Sleep:
After surgery, it is often challenging to sleep for one or two weeks. The operation itself can affect your sleep-wake cycle. Also, many patients experience an increase in shoulder pain, lying on their backs. We recommend that you sleep in a recliner or a reclined position in bed. It is often much more comfortable. You can place a pillow between your body and arms, elbow to keep your shoulder away from your body. It often helps with pain. You must wear a sling while you sleep.
Driving:
Operating a motorized vehicle can be difficult because you cannot work the shoulder that got surgery. Driving decisions based on your comfort level with one-handed driving. If you need to drive, you should wait at least until you see your doctor at the first postoperative visit. After the use of a sling, you can drive. No one can drive a car while using narcotics. Please limit driving as long as you are using those drugs.
Recovery:
- Recovery from arthroscopic surgery is usually faster than repair of a torn tendon. Because open tendon repairs are more involved, you may experience more pain soon afterwards.
- No matter what operation you have, full recovery will take your time. You should use a sling for about six weeks to protect your shoulder and gives the rotator cuff time to heal. You are driving prohibited for at least one month.
- Most people don’t get immediate pain relief from surgery. It can take several months for your shoulders to feel better. Until then, your doctor will advise you to take over-the-counter painkillers.
- Physiotherapy is an essential part of your recovery. Your doctor will give you exercise every day, or you can work with a physiotherapist. The movements you learn will help you regain arm strength and freedom of movement.
- Although it is difficult to recover from rotator cuff surgery, most people return to their routine within six months.
Conclusion:
Remember that every patient, every tear and every operation is a little different. Although these steps are useful guidelines, each patient must discuss their progress with their surgeon. Growth may be faster or slower, depending on several factors. Although it’s tempting to compare progress with friends, family members, or new acquaintances from the treatment room, their recovery may not be the same.
Make sure you know where you need extra protection or extra time to bring your shoulder to normal function. For more care after surgery and for treatment option on rotator cuff injury, contact the best shoulder surgeon, Dr Chandra Sekhar, in Hyderabad at 9959588389.
