Rotator Cuff Surgery 101

Your rotator cuff is an assembly of muscles and tendons in your shoulder that provides a wide range of motion. It also secures the shoulder joint into the socket. Because of how often you use your rotator cuff, it is not uncommon for the nerves or tendons to tear. When this happens, you can likely treat the condition at home. Your doctor may recommend that you ice the shoulder to reduce swelling and take aspirin or ibuprofen to alleviate pain. However, if at-home measures don’t work, you may have to get surgery. Typically, shoulder surgery is necessary after your shoulder cuff undergoes blunt trauma, such as a fall or after years of wear and tear.

When Doctors Recommend Rotator Cuff Surgery

Typically, your doctor will only recommend surgery if your shoulder does not heal with conservative, non-surgical treatment. Because a torn rotator cuff can take a significant amount of time to heal, your physician may not recommend surgery until after you have tried at-home methods for six to 12 months. If the pain continues beyond the six- to 12-month mark, your doctor may send you to a surgeon for a consultation. Some other reasons your doctor may recommend you for surgery include:

You are very active and use your arms for overhead work on a consistent basis
The tear in your cuff is larger than three centimeters and the quality of the surrounding tissue is still good
Your shoulder is very weak, and you have a significant loss of function
The tear in your cuff is the result of an acute and recent injury

Rotator cuff surgery does not look the same for everyone. There are three different types of surgery a surgeon can perform: open repair, all-arthroscopic repair and mini-open repair. As its name suggests, open repair is the most invasive type of shoulder surgery procedure. It is typically required if the tear is large or complex. Mini-open repair is the second most invasive type of shoulder surgery and requires the surgeon to make an incision that is three to five centimeters in length. An all-arthroscopic repair is the least invasive. During this procedure, the surgeon will insert a small camera into the shoulder joint and use the images to guide miniature surgical tools.

The type of repair the surgeon performs depends on the size of your tear, the quality of the surrounding tissue and bone, and the surgeon’s experience. However, each method achieves similar results in terms of strength improvement, pain relief and overall improved quality of life.

What to Expect After Surgery

The recovery process typically takes months and occurs in stages. For the first four to six weeks following your surgery, you will have to wear a sling and keep your arm immobile. Once your doctor determines it is okay to do so, you may begin passive exercises to improve your range of motion. After another four to six weeks, your exercise routine may become more intense. Eight to 12 weeks later, your therapist may allow you to perform strength training exercises. In total, you should expect the recovery process to take four to six months.

If you have pain in your shoulder, or if you sustained an acute injury in your shoulder, talk to your doctor about how to achieve improved strength and function.