Mobility and support for the arm are provided by a group of tendons known as rotator cuff. Sometimes you tear this when you overexert or injure yourself. You need to connect torn tissues through a surgical procedure.
Causes for Shoulder Tendon Injury
The most likely cause for the torn tissue is excessive wear. When you use your arm in a manner such that the force is above the normal, the supporting tissues will tear. Injury happens when you overuse your arm; muscles and tendons connecting muscle to bone can tear partially or completely. Overuse of rotator cuff can result in tendonitis. This type of inflammation of the tendon happens when you stretch upwards while playing a game or doing activity such as painting the ceiling.
Bursitis is the medical condition when the bursa sacs that are filled with fluid for providing smooth movement of the arm and rotator cuff becomes inflamed. This happens when you injure yourself.
Injuries to rotator cuff tendon happen mostly to young people who overexert themselves. If they carry things that have great weight or indulge in activity that requires them to keep their arms lifted up for long durations they could tear their tendons or muscles. Athletes, artisans like painters or carpenters, tennis and baseball players, rowers and wrestlers too are susceptible to this injury.
Symptoms That Indicate a Torn Cuff
- Feel weakness while moving your arm and shoulder
- Pain in the shoulder
- Lack of progress when you start exercises for the shoulder and arm
Testing for signs of injury
Diagnosing this ailment involves combining examination of patient physically and doing some diagnostic tests. The doctor will look at the medical records of the person to understand how injury occurred or could occur. During testing process, examining physician will determine extent of range of movement and strength of the arm of patient. He will eliminate extraneous possibilities for example possibility of arthritis or pinched nerve.
Using ultrasound imaging scans or other laboratory methods like magnetic resonance imaging (MRI scans) bone spurs that could rub against tendons is identified. These are the reason for weakness and swelling. Once he identifies how big the tear is and how the soft tissues are placed, your physician should know exactly what to do.
Treatment process comprises of surgical and nonsurgical procedures. Surgery is resorted to when pain or weakness in the arm does not show any signs of improvement even after 8 – 10 months of therapy.
Non-surgical treatment methods for tear or inflammation of tendons involve the following:
- Exercises that help improve motion and extent of reach of arm
- Isolating arm movement by resting arm in sling
- Reduce swelling in shoulder by use of hot and cold pack
- Use of steroid cortisone in affected area to bring down swelling
- Use OTC anti-inflammatory medication such as ibuprofen
How the Surgery Is Carried Out
Surgery is advocated if tear of shoulder tendon happened recently. The patient does not have chronic problems related to rotator cuff and requires the arm for daily activity like playing or while working. Make sure that you recover completely and rotator cuff surgery recovery is sure before you try to do any heavy work. You can achieve this in the following two ways.
For the first case, a large incision is made and deltoid (a large muscle) is moved away. You reuire this type of surgical procedure when tear is complex or broken pieces of bone remain in the region that need to be removed.
When injury is not too severe, arthroscopy is done. Here, small incisions about the size of a button are made in shoulder area. Arthroscope and instruments are inserted through opening to survey and carry out surgery and repair.
Aim of the surgery is to create an opening in area of tear allowing operating surgeon to remove broken pieces of bone along with damaged pieces of muscle and connective tissue (debridement). Fibers of the tendon are bunched and
sewed together. Following this tendon is attached to top of humerus bone. More space is allocated for facilitating movement of tendon by either shaving the bone or removing bone spurs. This helps to avoid irritation to tendon.
Risks Involved In the Operation
All medical procedures carry a certain amount of risk. In this case, risk in going through the operation may be surgical or related to anaesthesia used for surgery.
- Breathe related problems
- Patient may show allergic reaction to medicines
- Problems arising from clotting of blood
Further, there is always the chance that patient does not recover fully after surgery. Mobility and strength of shoulder and arm may not be realized fully. In addition, surgeon may damage some other tendon or blood vessel while conducting operation.
Preparing For the Procedure
Two weeks before going through surgery, they will ask you to provide list of medicines you normal take for any other medical condition that you have. Surgeon will inspect the list and ask you to stop certain medicines that will impede normal clotting of blood for example aspirin, naproxen or ibuprofen. Patients having other medication do not have any worries.
You might have to ask advice from your medical care provider regarding undergoing surgery if you suffer from and are taking treatment for conditions like heart disease or diabetes. In addition, you have to apprise your surgeon about any other sicknesses like flu or cold. And smokers will do well to stop during this period and after for at least one month.
On day of the operation, you will also have to follow certain things that you will be given. This will involve your diet and timing for your meals and medication.
Recovery after the operation
After the surgery is done, your shoulder is immobilized with an immobilizer and your arm is in a sling. Both immobilizer and the sling are needed for at least 30 – 40 days. Recovery could take 5 – 6 months. Once shoulder has stabilized, physical therapy will be started. This helps you develop normal motion and strength in your arms.
Though the prognosis is good, there still remains the chance that you will not recover strength fully. In addition, you can expect to have stiffness and chronic pain. Recovery time will vary depending on how bad the tear is.