Rotator Cuff Injuries and Treatment for Shoulder Pain (Q&A)


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.