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Rotator Cuff Tears

Rotator Cuff Tears & Treatment: A Closer Look

Diagnosis

During the physical exam, your doctor will press on different parts of your shoulder and move your arm into different positions. He or she will also test the strength of the muscles around your shoulder and in your arms.

In some cases, he or she may recommend imaging tests, such as:

  • X-rays. Although a rotator cuff tear won’t show up on an X-ray, this test can visualize bone spurs or other potential causes for your pain — such as arthritis.
  • Ultrasound. This type of test uses sound waves to produce images of structures within your body, particularly soft tissues such as muscles and tendons. It allows dynamic testing, assessing the structures of your shoulder as they move. It also allows a quick comparison between the affected shoulder and the healthy shoulder.
  • Magnetic resonance imaging (MRI). This technology uses radio waves and a strong magnet. The images obtained display all structures of the shoulder in great detail. The quality of the images depends greatly on the quality of the equipment used.

 

Treatment

Conservative treatments — such as rest, ice, injections, and physical therapy — sometimes are all that’s needed to recover from a rotator cuff injury. If your injury is severe, you might need surgery.

Surgery

You had a procedure called open rotator cuff repair. The rotator cuff consists of the muscles and tendons that surround your shoulder. The rotator cuff keeps the top of your upper arm bone (humerus) securely in the shoulder joint. Your doctor made an incision near your shoulder blade and repaired the torn muscles or tendons in your shoulder. Here are instructions to follow when caring for your arm at home.

Activity

 

Man leaning over with back straight, supporting himself on back of chair with one hand. Other arm is hanging from shoulder with arrows showing arm moving in circle.
You may be told to do daily “pendulum swings” to improve your joint’s flexibility. Use your torso to move your arm in a circle as it hangs straight down, make circles with your hand first in one direction, then the other.

 

  • After surgery, rest your arm and relax for the rest of day.
  • If you were asleep during the procedure (under general anesthesia), don’t operate power tools or machinery, drink alcohol, or make any major decisions for at least  24 hours after surgery.
  • Wear your sling, brace, or immobilizer, as directed.
  • Don’t drive a car until your doctor says it’s OK. And never drive while taking opioid pain medicine.
  • Flex your wrist and wiggle your fingers often to help blood flow.
  • Your doctor may recommend pendulum exercises after your surgery. If this recommendation is made:
    • Hold on to the back of a chair, or lean on a tabletop with your healthy hand.
    • Let your arm hang straight down toward the floor and use your torso to move your affected arm in a circle. First do  20 circles in one direction. Then do  20 circles in the other direction.
    • Repeat the pendulum exercise every  2 hours  while you are awake. When you feel ready, increase the number of circles to 50 in each direction every  2 hour s.

Incision care

  • Check your incision daily for redness, tenderness, or drainage.
  • Don’t soak in a bathtub, hot tub, or pool until your doctor says it’s OK.
  • Wait several days after your surgery to start showering, or until your doctor says it’s OK. Then shower as needed. Carefully wash your incision with soap and water. Gently pat it dry. Don’t rub the incision or apply creams or lotions.
  • Your incision was closed using sutures, staples, or strips of tape. If you have sutures or staples, they may need to be removed up to  2 to 3 weeks after surgery. Allow the strips of tape to fall off on their own.

Home care

  • Use pain medicine as directed by your doctor.
  • Apply an ice pack or bag of frozen peas—or something similar—wrapped in a thin towel on your shoulder to reduce swelling for the first  48 hours. Leave the ice pack on for  20 minutes; then take it off for  20 minutes. Repeat as needed.
  • Take your temperature daily for  7 days after your surgery. Report a fever above  100.4° F ( 38° C)  to your doctor. Fever may be a sign of infection.

Follow-up care

Follow up with your healthcare provider, or as advised.

Call 911

Call 911 right away if you have any of the following:

  • Chest pain
  • Shortness of breath

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

  • Shoulder pain that gets worse even after taking pain medicine
  • Pain or swelling in the arm on the side of your surgery
  • Numbness, tingling, coolness, or blue-gray color of your arm or fingers on the side of your surgery
  • Fever of  100.4° F ( 38°C) or higher, or as directed by your healthcare provider
  • Shaking chills
  • Drainage,oozing, redness, or warmth at the incision or bad smell
  • Nausea or vomiting

For specific instructions from your surgeon, please visit the post operative page.