Rotator cuff tear

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What are the signs of a rotator cuff tear?

A rotator cuff tear causes the tendon to detach from the humerus. Most tears affect the supraspinatus tendon but may also involve other parts of the rotator cuff. Pain during exertion combined with weakness in the shoulder are often observed and are sometimes accompanied by a decrease in mobility. An MRI (magnetic resonance imaging) scan or an ultrasound is needed to confirm a diagnosis.

Possible repercussions

Rotator cuff tears can gradually sneak up on patients due to rubbing, chronic impingement, or trauma. A completely torn tendon (full-thickness tear) means that the detached muscle will atrophy and turn to fat. Unfortunately, chronic atrophy is irreversible.

Non-surgical treatments

There are several treatment options other than surgery for people with torn rotator cuffs.

  • Some small or less painful tears can be treated with physiotherapy.
  • Cortisone shots are used with caution, as they can make tears worse.
  • Some overly chronic (inoperable) tears may be treated with physiotherapy or cortisone injections.
  • Surgical treatment

    In cases of a significant loss of function, the shoulder requires surgical repair. The sooner a tendon is repaired following the tear, the greater the patient’s chances of making a full recovery with no lasting repercussions.

    About the procedure

    • Outpatient arthroscopic procedure (very small incisions using very small surgical instruments)
    • Length of procedure: 45 to 90 minutes

    • Regional anesthesia (the entire arm and shoulder are blocked) by an anaesthesiologist. The patient remains conscious during the procedure.
    • If the patient would like to be sedated, a mild, short-acting sedative can be administered.

    Post-surgical recovery

    Patients may be escorted home approximately one hour after their procedure. Numbness in the shoulder wears off after approximately 6 to 18 hours. It is recommended that patients take pain relievers during the first few days after surgery. A post-operative follow-up is required two weeks after the procedure to remove the patient’s stitches.

    About recovery

    • Non-physical activities may be resumed the next day if pain levels permit.

    • Non-strenuous activities may be resumed several days post-surgery (cooking, driving, writing, typing).

    • Pendulum exercises must be performed starting the first several days to minimize the formation of adhesions.

    • Patients can resume more strenuous activities after two to three months (exercise, swimming, tennis, carpentry). It is important to let the shoulder heal before starting strengthening exercises so as to avoid any new tears.

    • Recovery rate: 90%
    • Complication rate: less than 1%

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