Discuss the Rotator Cuff Recovery, Problems, Physical Therapy, Operation, Muscles, Damage, Bursitis

Rotator cuff recovery from a rotator cuff injury or surgery can be a long, complicated process. Rehabilitation post-surgery is one of the biggest downtimes of rotator cuff procedures.

If the injury is mild, your surgeon’s rotator cuff recovery instructions will be that you completely rest the injured shoulder until it recovers. Mild inflammations and inflamed bursae can be treated with rest and physical therapy, after a thorough checkup and MRI scan to ensure there are no secondary complications.

Rotator cuff recovery from a more serious injury would require that the shoulder be bound in a tight tape bandage that cannot be removed easily. Since the shoulder is one of the main areas of the body and therefore involved in many different body movements, keeping this area immobile is very essential to recovery.

Inflammations are mostly treated using steroids. Once the inflammation reduces, the shoulder is moved in particular ways using physical therapy procedures. The initial movements are meant to get the shoulder get used to lifting the arm. The more complex exercises allow the shoulder to remember how to rotate the arm and how to pull objects.

Rotator cuff recovery from surgery is the toughest. If the surgery is arthroscopic, recovery includes the same process as when the rotator cuff is injured. Usually, surgery is not recommended unless the rotator cuff is torn all the way through the tendon. For mild tears, physical therapy and rest are the prescribed norms.

Once the tear in the tendon is stitched up, the shoulder is bound and packed tightly into a sling. Rotator cuff recovery doesn’t take too long if the patient responds well. In the case of open surgery, rotator cuff recovery can take a long time because the larger incision has to heal and the pain is more severe.

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Rotator Cuff Problems

Symptoms of rotator cuff problems are pain and weakness when holding the arm up over the head or when stretching it out horizontally. Painful symptoms of rotator cuff problems may surface when dressing, sleeping, brushing hair, or any activity that involves moving the arm in an outward or upward motion.

Pinpointing the exact source of the symptoms of rotator cuff problems may be difficult but the weakness can be apparent to a doctor during the physical exam. X-rays may look normal and partial tears aren’t always visible to the eye even when using imaging technology such as MRIs.

If the symptoms of rotator cuff problems point to the diagnosis, non-invasive treatments are normally prescribed before invasive treatments such as surgery are considered. The first treatment of rotator cuff problems tendon is usually applying hot or cold packs to the painful area and treatment with anti-inflammatory medications such as oral NSAIDs or ibuprofen. A sling may also be prescribed so the arm that is affected by the torn rotator cuff can rest.

In addition, electrical stimulation of the muscles and nerves, ultrasound, and steroid injections may be recommended for the treatment of a torn radiator cuff. If these non-invasive treatments are not successful at alleviating the

symptoms of rotator cuff problems, arthroscopic surgery or an open repair of the rotator cuff tear may be pursued. After arthroscopic or open surgery is performed extensive physical therapy may be required to regain strength and normal range of movement.

Rotator Cuff Physical Therapy

After a rotator cuff surgery has taken place, the shoulder joint needs to be exercised in order to get the four rotator cuff muscles moving in coordination again. A certain amount of stiffness and pain results based on the seriousness of the injury and the kind of surgery that took place.

Rotator cuff physical therapy begins only after the surgery has healed completely. In the case of a diabetic patient, aggressive physical therapy might cause the tear to open up again and a high degree of care has to be employed.
Before the physical therapy begins, the therapist will likely place a hot compress on the shoulder area to relax the muscles. Rotator cuff physical therapy involves slowly swinging the arm back and forth and from side to side in small circles while holding the arm like a pendulum. After a few days of this, the arm is lifted forward and from side to side. A jump rope and a pulley are used to pull the arm behind the body and bring it forward again.

This rotator cuff physical therapy is followed by shoulder raises where the shoulders are moved back until the shoulder blades touch. After the exercises, a cold compress is applied on the shoulder and electrode pads are stuck to the shoulder while a mild electric current is passed through them. This activates the muscles and improves movement while reducing any inflammation caused by the exercises.

After the basic physical therapy, exercises that are more complex are recommended such as lifting the arm high while holding a wooden bar and turning the arm around to test the rotator cuff’s movements. Rotator cuff physical therapy will continue for a couple of weeks or more depending on the severity of the injury.

Rotator Cuff Operation

Rotator cuff operation is a surgical procedure that is undertaken to repair tears and severe injuries in the rotator cuff muscles of the shoulder joint. Injuries to the shoulder joint mostly mean injuries to one or more of the four rotator cuff muscles. If surgery is decided, then the type and severity of the rotator cuff operation depend on whether the rotator cuff muscle tear is of partial thickness or full thickness.

Even if only one of the four rotator cuff muscles is injured, the shoulder may or may not hurt much. This is because tendons don’t have nerves attached to them. If one muscle is injured, and the other three are still attached, the patient will be able to have relatively good function of the shoulder until degeneration starts.

These days, rotator cuff operation takes place arthroscopically.  Small incisions are made into the shoulder under general anesthesia or a local nerve block. The surgeon uses tiny instruments at the end of which minuscule video cameras are attached. The surgeon is able to watch the path of the instruments via the cameras on a television screen. The surgeon locates the rotator cuff muscle tear and stitches it up using self-dissolving stitches. Once the rotator cuff operation is complete, the entire shoulder is wrapped uptight and a strong sling is applied with strict instructions not to move it.

The sling is supposed to be kept on for a couple of weeks after the rotator cuff operation for complete healing to take place. Open rotator cuff operations usually cause a lot of pain, which is now avoided by managing minor rotator cuff operations using arthroscopic techniques. If done properly, recovery should be quick and the patient should be able to resume normal activities within a few weeks.

Rotator Cuff Muscles

The rotator cuff has four muscles in it, which come together at the shoulder to form a thick cuff over the shoulder joint. The rotator cuff’s job is to stabilize the shoulder and enable the shoulder to lift and rotate the arm. Rotator cuff muscles are extremely important for any movement of the shoulder. Each rotator cuff muscle originates on the shoulder blade and goes into the arm bone.

There are four rotator cuff muscles that originate in the shoulder blade and go into the armhole. These are responsible for lifting up the shoulder joint both internally and externally, rotating the shoulder joint, and allowing the arm to move freely.

If even one rotator cuff muscle is injured or a tear forms in it, the shoulder movement will be severely impacted. If the rotator cuff muscles are injured, the patient is advised to rest the shoulder completely and not use it in any way. Even typing on a keyboard causes the shoulder to move and the arms to lift and work. The patient has to rest until the injury heals itself. This works in the case of a minor injury that was perhaps earned during a tennis match. However, if the injury is major, the shoulder needs to be put in a cast till the healing occurs, supported by medication for pain and internal healing.

If a rotator cuff muscle is actually torn, then a surgeon has to get involved. Depending on whether the tear is a partial thickness or a full-thickness tear, surgical decisions are made. Usually, rotator cuff muscles surgery would involve open surgical techniques. However, arthroscopic surgeries are catching on for rotator cuff muscles surgery and the results are positive.

With either kind of surgery, post-operative rehabilitation of the shoulder can be an intricate and complicated aspect of recovery.

Rotator Cuff Damage

In the case of rotator cuff damage, a doctor’s exam and your symptoms may go further in figuring out what the problem is than tests like X-rays and MRIs. Many times rotator cuff damage is difficult because X-Rays can look normal and small tears cannot always be seen even with imaging technology.

Pain and weakness are classic symptoms of rotator cuff damage, so is a pain when dressing or doing something as simple as brushing your hair. If you have these symptoms it is likely that you will receive a diagnosis of rotator cuff damage from your doctor. When you first receive a rotator cuff damage diagnosis, your doctor may put the affected arm in a sling to rest your shoulder and recommend that you take NSAIDS or ibuprofen for the pain and inflammation.

Depending on the severity of the pain, he may prescribe a round of physical therapy or send you home with some exercises to strengthen the muscles in your shoulder. This is standard procedure with rotator cuff damage. Other conservative treatments that your doctor may prescribe if you have rotator cuff damage are hot or cold packs, ultrasound therapy, and cortisone shots.

If you have received a rotator cuff damage diagnosis and the pain doesn’t improve after a while your doctor may recommend surgery. With rotator cuff damage arthroscopic surgery is the less invasive procedure but an open procedure can sometimes be required. After the surgery is complete physical therapy is usually recommended to regain strength and range of motion in the shoulder and arm.

Rotator Cuff Bursitis

A bursa is a soft sac that is filled with fluid, which helps to lubricate and cushion soft tissue surfaces that undergo friction. A bursa basically helps reduce friction and keeps the movement smooth.

In the shoulder, bursae are located between the shoulder blade and the rotator cuff. An inflamed or irritated bursa causes bursitis. Bursitis is usually accompanied by pain and swelling of the shoulder joint.

The symptoms of rotator cuff bursitis are pain or swelling, pain when the shoulder is moved and tenderness in the injured area. Doctors check the injured area using X-ray testing to see if the rotator cuff bursitis is chronic or recurrent. MRI scanning can also help identify rotator cuff bursitis.

If the rotator cuff bursitis is not infected. Uninfected rotator cuff bursitis can be treated with rest, ice compresses, and pain and anti-inflammatory medications. The fluid might need to be removed to relieve symptoms. The bursa fluid is removed with a needle and syringe in a sterile environment.  The fluid is sometimes sent for further analysis depending on the patient’s medical history.

If the rotator cuff bursitis is not infected, it can be treated with steroid injections given directly into the inflamed bursa. This can be done at the same time that the bursa is drained. Sometimes a patient is prescribed physical therapy to help with the recovery, especially when the patient complains of a frozen shoulder.

If the rotator cuff bursitis is infected, the treatment has to be more aggressive.  The bursa will have to be drained and the fluid examined to identify the infection-causing microbes. The patient will need to be given antibiotics. Care needs to be taken and the rotator cuff bursitis will have to be watched for secondary infection. This can get a little complicated if the patient happens to be a diabetic.