When Shoulder Pain Requires Surgery
People of any age can experience a rotator cuff injury. The rotator cuff is a group of muscles and tendons located in the upper arm that connect the humerus bone to the shoulder blade. The tissues are critical for proper motion. Common signs of an injury include shoulder weakness, reduced range of motion (ROM), hesitance to move the joint, and pain, especially when lifting, pulling, or reaching overhead. Rotator cuff repair can help, and knowing what to expect post-op, such as when the arms can be raised overhead again, allows the patient to prepare for surgery.
Causes of rotator cuff injuries
Various contributing factors can cause a rotator cuff injury, but general wear and tear is a common culprit. Poor posture, like slouching or pushing the head forward, can also contribute to shoulder damage. Additionally, repetitive stress caused by performing the same movements over and over can also cause damage. Athletes such as tennis and baseball players, and even swimmers, are at a higher risk for a rotator cuff tear because of repetitive overhead motions.
Is surgery the only option?
While rotator cuff surgery is common, not all individuals with the injury are good candidates for the procedure. Often, surgery may not be recommended unless other conservative treatment methods have been attempted. People with minor damage may be encouraged to try non-invasive at-home treatments such as rest, icing the area, and even special strengthening exercises. If the above options don’t offer improvement within 6 months of the initial injury, or if shoulder weakness impacts daily life, surgery may be recommended. Likewise, athletes are more likely to be encouraged to pursue surgery as a primary solution.
What to expect from surgery
Rotator cuff surgeries can be performed as open surgery, arthroscopic, or mini-open repair. Regardless of the method used, most people who undergo the procedure are discharged on the same day. Open surgery requires the largest incision since the shoulder will be exposed. Meanwhile, arthroscopic surgery is the most minimally invasive and relies on guiding a camera scope and smaller surgical tools through tiny incisions to repair the damage. Finally, a mini-open repair combines both traditional open surgery with an arthroscopy. While the arthroscopic portion is used to locate and remove damaged tissue and bone, the surgical area may still need to be opened to fully repair the shoulder.
Recovering from surgery
Keep in mind that individual recovery times can vary based on the severity of the injury and other factors such as patient health or adherence to recovery guidelines. For smaller tears or damage, expect to be fully healed within 4 months. More significant injuries may take up to 6 months to regain full function. Severe damage may require 6-12 months. Non-athletes are usually permitted to return to previous activities within 12 weeks after surgery. Athletes are often prohibited from vigorous actions like throwing overhead for 4-6 months.
Get back to normal life
A critical factor influencing how quickly a person returns to previous activities after surgery is whether physical therapy (PT) occurs consistently. After the first week of surgery, surgeons typically encourage patients to begin a therapy routine lasting 3-4 months. Individuals should wait at least 6 weeks before lifting the arm overhead. As long as there is no pain, patients can slowly start re-integrating activities that involve overhead motion back into the routine. Rotator cuff repair requires patience, but with a commitment to PT, patients can put those hands in the air again in no time.
