Do I Have to Have Surgery For a Rotator Cuff Injury?

Do you suspect you may have a rotator cuff tear? Have you been examined by a doctor who told you your rotator cuff may be torn? Perhaps you had an MRI that showed rotator cuff tearing or tendonitis?

You may be very worried about your shoulder and symptoms you may be having such as pain, weakness, and loss of motion. You may be worried about these problems getting worse, interfering with your sleep or ability to work, and reducing your quality of life. You may also be worried that this diagnosis means you will need surgery on your shoulder.

Do Rotator Cuff Injuries Require Surgery?

It is true that some rotator cuff problems do require surgery. However, there are many reasons to look forward to living the life that you love, working and playing without pain, and healing your shoulder…without surgical treatment.

At The Bone & Joint Surgery Clinic, surgery is usually only considered as a “last resort,” when all other non-surgical treatment options have failed.

What Does Rotator Cuff Repair Treatment Involve?

Your path to healing always begins with a personal visit with one of our orthopaedic physicians. They will ask you many questions about your shoulder pain:

• When did it begin?
• Was there an injury or did it quietly get worse over weeks or months?
• Do you have any history of old injuries to the shoulder?
• What things make it better or worse?
• Where is the pain?

X-Rays will likely be obtained, and the physician will examine your shoulder to determine the cause of your pain and your exact problem.

Treatment may often consist of simple watchful waiting, especially if you have good strength and motion of your shoulder and your pain began recently.

However, anti-inflammatory medication and physical therapy, either at home or with a therapist, is usually recommended as well.

Reducing inflammation and improving and maintaining your strength and range of motion is always a good idea, even if you have had an injury that continues to improve.

If your pain is very severe, your orthopaedic doctor at The Bone & Joint Surgery Clinic may recommend or offer a steroid injection.

Think of these like an anti-inflammatory medication you take by mouth, only it is targeted to the area that is generating your pain. These can be very effective and help to settle inflammation in the involved shoulder, especially while therapy is started to fix the underlying problem.

If you have signs and symptoms that are very worrisome, such as severe weakness, loss of motion, or persistent pain despite therapy and medications, your surgeon may obtain an MRI to evaluate your rotator cuff and shoulder joint.

This is especially the case if you are young or very active. Your surgeon at The Bone & Joint Surgery Clinic will personally review the MRI and talk to you about what it shows.

Another option is ultrasound. In some situations, your orthopaedic provider may be able to use ultrasound to evaluate for tearing of the rotator cuff. This can provide reassurance and peace of mind to both the patient and doctor when the goal is to rule out major injury.

It is also very important to keep in mind that rotator cuff tears usually happen at the same time as other shoulder problems.

Stiffness and inflammation, a combination often known as “bursitis” or “frozen shoulder,” often occur along with rotator cuff tears and usually respond to non-surgical treatments.

As we age, many of us have small tears in our rotator cuff that do not cause pain, and your orthopaedic doctor at The Bone & Joint Surgery Clinic will determine if the rotator cuff tear is simple painless “wear and tear” or if it is the source of your pain.

How Does the Rotator Cuff Work?

It is helpful to think of the rotator cuff like a thick rope made out of many small strands or threads. If some of the threads break and tear, that is OK because the rest of the threads are intact and the rope is still able to stand up to pulling and heavy loads.

However, if all the threads break and the rope snaps completely, this is a more serious problem because the rotator cuff muscle can no longer function at all. This is the most common reason why patients have rotator cuff repair surgery.

Our Experienced Orthopaedists Are Partners in Your Care

If you have questions and concerns about your shoulder or other bone, joints, ligaments, or tendons, the orthopaedic care teams at The Bone & Joint Surgery Clinic are here for you.

Our experienced specialists will give you all the information you need and will make decisions WITH you, not for you.