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One of the most frequent musculoskeletal injuries is the rotator cuff injury. Sometimes this type of injury is not associated with symptoms, but usually it is quite painful. A rotator cuff tear or rotator cuff tendonitis can cause you to experience pain and weakness in the shoulder when using your arms. It can be especially painful to lift the arm higher than shoulder level. Luckily, there are a number of ways to treat rotator cuff injuries - both surgical and non-surgical. The type of injury you have, your condition, and your age will be determining factors in deciding which type of treatment is right in your situation.

Rotator cuff injuries occur in two ways. You could either have rotator cuff tendonitis or a rotator cuff tear. It is important to realize that there are a few other conditions that can cause the type of pain one experiences with a rotator cuff injury. For an accurate diagnosis, you will need to see your physician. The first step your physician will take is a physical examination. Following the examination, your doctor may inject your injured shoulder with a local anesthetic. This process will help your doctor in determining exactly what kind of injury you have. If your doctor decides that you have a rotator cuff tear, he or she may send you for some imaging tests. Imaging tests will help pinpoint the location of the injury and confirm whether or not the injury is a tear.

The more common diagnosis is rotator cuff tendonitis. Treatment for rotator cuff tears and rotator cuff tendonitis is quite similar. Both may be treated conservatively with rest, ice, compression and elevation (known as RICE) therapy. Additionally, an over-the-counter anti-inflammatory like ibuprofen is recommended. The physician may make a referral to a physical therapist for exercise therapy and modification methods that will help with ADL (activities of daily living). Persistent pain caused by tendonitis may be treated with local injections of a steroid/anesthetic mixture. This will help relieve pain in the joint.

Of the patients who use this non-surgical intervention, about half report having a decrease of pain and an increase in range-of-motion within six weeks to three months. Aside from efficacy, there are a number of advantages to non-invasive therapy. Surgical risks such as permanent stiffness, anesthesia complications, and infection can be completely avoided. With non-invasive therapy, there is no down-time for recovery. On the other hand, use of non-invasive techniques may cause an increase in the size of the tear. While there is not a recovery period, there may be a time period when the patient is able to do less. Of course there is also the chance that the non-invasive technique simply will not work. In this case, your doctor may recommend surgery. Your doctor may also recommend surgery if your injury is so severe that he or she feels a non-invasive approach would not be effective.

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Rotator cuff injuries can be treated surgically in three ways:

The first way is open repair surgery. When open repair surgery is chosen, the surgeon will make a full incision into the shoulder. This large incision has the potential of leaving a large scar; however, this method allows the surgeon to have a great deal of freedom of movement.

Another method that utilizes both an incision and arthroscopy is called mini-open repair surgery. This is an outpatient procedure in which the surgeon makes a smaller incision and uses an arthroscope to see the interior of the shoulder structure. This procedure leaves a much smaller scar.

3. All arthroscopic surgery: This option is an outpatient procedure, and it uses the smallest incision.

After examining and diagnosing your injury, your doctor will be able to make a sound decision as to which method will work best for you.

The majority of patients who have rotator cuff surgery experience a decrease in pain and an increase in ROM (range of motion) within four to six months following surgery. In fact, eighty to ninety-five percent of people who have this surgery report satisfaction with the results.

The success of your recovery is dependent on a number of factors. Among them are, your surgeons level of expertise, your fitness level, the severity of your injury, and your compliance with your doctors instructions.

Complications resulting from rotator cuff surgery are quite rare. The most commonly experienced complication is tendon re-tear. This is only experienced by about six percent of patients. Nerve injury may be experienced by one to two percent of patients. Infection may be a problem for one percent of patients. Fewer than one percent complain of stiffness. Less than one percent may have problems with deltoid muscle detachment.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Portland ACL Tear and Portland Knee Doctor.