Rotator Cuff Repair
The rotator cuff is comprised of four muscles attached to tendons that attach to bone. Each pair of muscle tendon units comprise a force couple that balance the shoulder. A balances C, B balances D. These balanced muscles create the force to position your hand to perform daily tasks like lifting a cup of coffee or reaching into the pantry for the ketchup. However, when A is torn, C pulls against no resistance and the shoulder is out of balance. This imbalance produces pain and dysfunction. It can inhibit daily activities and wake you up at night. For small tears or partial thickness tears, a cortisone shot to calm the inflammation and physical therapy to regain strength can be helpful to restore function. The cortisone shot is important to decrease the inflammation and pain so that the exercises can help you regain strength in your shoulder. You can’t “push through the pain. Your shoulder muscles will not get stronger and the purpose of the therapy is defeated. About half the people who have these partial tears do not require surgery. For the other half of patients with the partial thickness tears, the tears progress to full thickness tears and many of these require surgery for pain relief and restoration of function. For larger tears that produce greater pain and dysfunction, surgery can produce reliable results as long as you don’t wait too long.
The surgery is performed at an outpatient surgery center under a nerve block and a light general anesthesia called “twilight.” The surgery lasts one to two hours and you go home the same day. We prescribe pain medication for the first few days as the nerve block wears off. We also recommend CBD oil under the tongue to help with the discomfort. You are in a sling for 6 weeks, start therapy at week 3 and regain full function at 6 to 8 months.