Rotator Cuff Tear/Repair
What is it?
The rotator cuff is actually a combination of muscles and tendons at the top of the upper arm that helps stabilize the shoulder joint and lifts and rotates the arm. The “cuff” of muscles attaches to the scapula (shoulder blade) with a tendon connected to the front and side of the humerus bone (upper arm). This network of muscles and tendons gives the shoulder more mobility than any other joint in the body.
Although injury to the rotator cuff can be the result of trauma, such as a dislocation or fracture, tears in any component of the rotator cuff are most often caused by overuse, called wear-and-tear injuries. Any sport or activity that requires repetitive arm movement, like tennis, weight lifting or painting, can lead to a rotator cuff injury. Those who develop tears through overuse may also have experienced several months of pain associated with inflammation, either bursitis, which is inflammation of the joint bursa (fluid), or tendonitis, which is inflammation of one or more tendons.
What are the treatment options?
Sometimes all that is needed for a rotator cuff injury is rest, ice and physical therapy. If the injury is sever enough though and involves a complete tear of the muscle tendon surgery may be needed. There are a variety of surgeries that may be performed which include arthroscopic tendon repair, open tendon repair, bone spur removal, tendon transfer and shoulder replacement.
To reduce pain your doctor may recommend a steroid injection to the shoulder joint.
What to Expect
• You may resume your regular diet. However, start slow with clear liquids and gradually work your way back to your normal diet. This will help prevent nausea and vomiting.
Shoulder Care & Bathing
• Keep your dressing and sling in place until your first post-op visit unless instructed otherwise
• Dressing will be changed at your first post-op appointment
• Tegaderm dressing will be placed which will allow you to shower immediately
• No bath or swimming until the bandages are removed
• If the tegaderm dressings become loose or fall off replace with over the counter water proof bandages
• Keep incision dry until sutures are removed
Elevation and Circulation
• Elevate as much as possible for the first 3-5 days you can achieve this by sitting up. Extra pillows to support your body, a pillow wedge and/or a recliner are some ways to make this comfortable for the first week or two.
• After these first few days, continue to elevate as needed in order to reduce swelling.
• To encourage circulation and decrease swelling, wiggle your fingers, thumb and wrist several times each hour.
• To help reduce pain and swelling, apply an ice pack to the surgical area for 20 to 25 minutes every one to two hours for the first 48 hours and then as needed to help control pain and swelling.
• To avoid frostbite, place a towel or t-shirt between the ice pack and your skin.
• It is not necessary to use ice while sleeping.
• We recommend the use of a cold therapy unit, which is often an out of pocket expense. The advantage of this unit is that the temperature can be regulated, allowing for continuous use for several hours at a time.
• Your physician will give you a written prescription for pain medicine as you leave the surgery center. Take your pain medication as prescribed. You may want to take it regularly for the first 48 hours after surgery. Do not take any additional Tylenol.
• While you are asleep in the operating room, a long acting numbing medication may be injected into the surgical area to help relieve your immediate postoperative discomfort for up to 24 hours. When you first notice tingling or throbbing, begin taking your pain medicine so it will become effective before the local anesthesia wears off.
• No driving while taking any narcotic pain medication!
• The pain medication may cause some nausea so take it with food.
• The pain medication and general anesthesia may also cause constipation, so you may need to take a stool softener, fiber bar, Metamucil or prune juice to prevent constipation.
• Watch for temperature > 101.5F, persistent numbness and tingling, persistent bleeding or drainage from the wound, foul odor, progressively worsening pain that is unresponsive to pain medication, chest pain or difficulty breathing. If you have any of these symptoms, call the office if during normal business hours or go to the nearest emergency room.
• Please make sure to follow instructions given to you by your physician, they may have specific instructions for your care.
• If you do not have a postoperative appointment set-up already, please call the office to schedule an appointment for 7-10 days after surgery at (785)843-9125.