Rotator Cuff Tear Treatment
Therefore in considering the treatment of chronic tears, the most crucial ingredient is time.
In my experience, there is an excellent chance that your pain will resolve or improve in the first three months. You must avoid aggravating activities to give your shoulder a chance to settle. Because the tissues around your shoulder are usually inflamed, a cortisone (an anti-inflammatory medication) injection may be helpful. Performing the cortisone injection under ultrasound guidance ensures they are delivered into the correct place and have a higher chance of success. Physiotherapy can also be beneficial. A physiotherapist can facilitate a home exercise program. Initially, this will comprise exercises to improve your movement. As the pain improves, you can start a gentle strengthening program.
Dr Brown has successfully treated many patients with rotator cuff injuries and is knowledgeable in the latest non-surgical and surgical treatments.
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Surgery may be required for acute traumatic tears in younger people or for more chronic ones that have failed to settle with treatment outlined above. An MRI scan of your shoulder is helpful to plan surgical repair. An MRI gives additional information including the size of the tear (from front to back), the thickness of defect (whether partial thickness or complete) and how far the tendon has retracted from the bone. The MRI will also look at the muscles of the rotator to see whether they are still in good condition. This additional information will help with surgical planning and will determine if the tear is repairable. Chronic large tears that have retracted a long way from their bony attachment, particularly if they are associated with muscle wasting, may be irreparable.
Surgery involves an arthroscopy of your shoulder to confirm the presence of a tear, its size and the general condition of the rotator cuff. These findings determine whether the tendon is suitable for a repair. Arthroscopic inspection of the shoulder determines the presence of other pathology. I repair smaller tears arthroscopically. More extensive damage is fixed openly, with a small incision placed on the outside part of your shoulder. The repair technique involves placing stitches into the tendon and then the use of small plastic anchors placed into the bone. These firmly hold the tendon in place to allow healing. Healing has usually occurred by three months from surgery, but the repair will be even more robust by six months. Though the tendon will take three months to heal, it may take longer for your movement to return and for you to get back to your usual activities.