Rotator Cuff Tears
Pain felt over the side of the shoulder (deltoid) usually comes from a problem with the rotator cuff. Initially this is most often inflammation of the tendon as it rubs against the bone ( rotator cuff impingement )
Presenting signs
Pain over lateral deltoid region, especially as the arm is lifted out to the side, but often improving as the arm goes high above the head ( painful arc)
Pain is often worse at night causing difficulty sleeping.
Initial treatment
This is aimed at relieving the pain and restoring normal shoulder movements and function.
1.Simple analgaesics such as Paracetomol and Ibuprofen (check for suitability with your doctor ) can help with the pain
Most people assume a shrugged posture due to the pain. This worsens and prolongs the problems and must be corrected.
2.Physiotherapy can be extremely useful for posture correction at this stage
3. If problems persist then an injection of steroid for pain relief with further physiotherapy may suffice
Surgical Treatment
If the treatment so far has not relieved the pain then a referral to a shoulder surgeon for discussion of surgical options is advised.
These include a sub- acromial decompression or a rotator cuff repair
Rotator cuff repairs
It is important to stress that not all rotator cuff repairs need surgical repair. Many people have cuff tears that they are unaware of and continue to have excellent function, others can manage well after a sub acromial decompression only
If the tear is substantial then an arthroscopic ( keyhole) repair may improve pain and function.
A substantial period of recovery is required with several months of physiotherapy and up to a year and a half before full recovery.
If the tear is massive then repair may not be feasible. In such cases a special type of joint replacement called a reverse polarity shoulder replacement may allow return of function and comfort
Presenting signs
Pain over lateral deltoid region, especially as the arm is lifted out to the side, but often improving as the arm goes high above the head ( painful arc)
Pain is often worse at night causing difficulty sleeping.
Initial treatment
This is aimed at relieving the pain and restoring normal shoulder movements and function.
1.Simple analgaesics such as Paracetomol and Ibuprofen (check for suitability with your doctor ) can help with the pain
Most people assume a shrugged posture due to the pain. This worsens and prolongs the problems and must be corrected.
2.Physiotherapy can be extremely useful for posture correction at this stage
3. If problems persist then an injection of steroid for pain relief with further physiotherapy may suffice
Surgical Treatment
If the treatment so far has not relieved the pain then a referral to a shoulder surgeon for discussion of surgical options is advised.
These include a sub- acromial decompression or a rotator cuff repair
Rotator cuff repairs
It is important to stress that not all rotator cuff repairs need surgical repair. Many people have cuff tears that they are unaware of and continue to have excellent function, others can manage well after a sub acromial decompression only
If the tear is substantial then an arthroscopic ( keyhole) repair may improve pain and function.
A substantial period of recovery is required with several months of physiotherapy and up to a year and a half before full recovery.
If the tear is massive then repair may not be feasible. In such cases a special type of joint replacement called a reverse polarity shoulder replacement may allow return of function and comfort
