Dealing with shoulder pain can make even the simplest daily tasks feel like a struggle. If you’re experiencing persistent pain, weakness, or a limited range of motion in your shoulder, a torn rotator cuff might be the culprit. At California Pacific Orthopaedics, our team of expert surgeons in San Francisco specializes in a minimally invasive procedure called arthroscopic rotator cuff repair to help you get back to the activities you love, without the debilitating pain.
This guide will walk you through everything you need to know about this common and effective surgery, from why it’s done to what you can expect during your recovery.
Overview: What is Arthroscopic Rotator Cuff Repair?
Your rotator cuff is a group of four muscles and their tendons that surround your shoulder joint. Think of them as a “cuff” that holds the top of your upper arm bone firmly in the shoulder socket, allowing you to lift and rotate your arm.
When one or more of these tendons tear, it can cause significant pain and weakness. An arthroscopic rotator cuff repair is a surgical procedure to fix these tears. “Arthroscopic” means the surgery is performed using a tiny camera, called an arthroscope, and small surgical tools inserted through small incisions. This is a minimally invasive approach, which means less pain and a quicker recovery compared to traditional open surgery.
Our surgeons at California Pacific Orthopaedics are highly skilled in this advanced technique, helping patients throughout the San Francisco Bay Area find lasting relief from rotator cuff injuries.
Why is Arthroscopic Rotator Cuff Repair Done?
Not every rotator cuff tear requires surgery. Many people find relief with non-surgical treatments like rest, physical therapy, and anti-inflammatory medications. However, your doctor might recommend surgery if:
- Your symptoms have lasted for 6 to 12 months without improvement from other treatments.
- You have a large tear (more than 3 cm).
- You’re experiencing significant weakness and loss of function in your shoulder.
- Your tear was caused by a recent, acute injury, like a fall.
- You’re an active individual who relies on shoulder strength for your job, sports, or daily activities.
The goal of the surgery is to reattach the torn tendon to the upper arm bone (humerus), which can relieve pain, improve strength, and restore your shoulder’s function.
Common Symptoms and Causes of a Torn Rotator Cuff
Rotator cuff tears are a common cause of shoulder pain, especially as we get older. Here’s what to look out for:
Common Symptoms:
- Pain at rest and at night, especially if you lie on the affected shoulder.
- Pain when lifting and lowering your arm or with specific movements.
- Weakness when lifting or rotating your arm.
- A crackling sensation (crepitus) when moving your shoulder in certain positions.
- Difficulty with everyday activities like combing your hair or reaching behind your back.
Common Causes:
- Injury: A sudden tear can happen if you fall on an outstretched arm or lift something too heavy with a jerking motion.
- Wear and Tear (Degeneration): Most tears are the result of the tendon wearing down slowly over time. This is more common in people over 40.
- Repetitive Stress: Repeating the same shoulder motions over and over can stress your rotator cuff muscles and tendons. This is common in sports like baseball and tennis, and in occupations like painting and carpentry.
- Lack of Blood Supply: As we age, the blood supply to our rotator cuff tendons can decrease, which impairs the body’s natural ability to repair tendon damage.
- Bone Spurs: Overgrowths of bone on the top of the shoulder blade (acromion) can rub on the rotator cuff tendon, causing a condition called “impingement” that can lead to a tear.
Common Risk Factors for a Rotator Cuff Tear
Certain factors can increase your risk of developing a rotator cuff tear:
- Age: People over 40 are at a greater risk.
- Certain Sports: Athletes who play sports with repetitive overhead motions, like baseball, tennis, and swimming, are more susceptible.
- Certain Occupations: Jobs that require repetitive lifting or overhead work, such as painters, carpenters, and construction workers, can increase your risk.
- Family History: There may be a genetic component to rotator cuff injuries.
- Smoking: Smoking can affect blood flow and slow down the healing process.
What to Expect: Before, During, and After Surgery
If you and your surgeon at California Pacific Orthopaedics decide that arthroscopic rotator cuff repair is the right choice for you, here’s a general idea of what to expect.
Before the Procedure:
- Consultation: You’ll have a thorough evaluation with one of our San Francisco-based orthopedic surgeons, which will include a physical exam and imaging tests. Most commonly this includes an MRI but in some cases an ultrasound may be ordered to confirm the diagnosis.
- Pre-operative Instructions: Our team will provide you with detailed instructions on how to prepare for surgery, including any restrictions on eating, drinking, or medications.
- Anesthesia: You’ll meet with an anesthesiologist to discuss the type of anesthesia that will be used. Most arthroscopic rotator cuff repairs are performed under a combination of regional anesthesia (a nerve block to numb the shoulder and arm) and a light general anesthetic.
During the Procedure:
- Small Incisions: Your surgeon will make a few small incisions (about the size of a buttonhole) around your shoulder.
- Arthroscopic Examination: The arthroscope is inserted through one of the incisions, allowing your surgeon to see the inside of your shoulder joint on a video monitor.
- Repairing the Tear: Using small surgical instruments inserted through the other incisions, your surgeon will reattach the torn tendon to the bone using sutures and small anchors. They may also address any other issues, like bone spurs.
- Closing the Incisions: Once the repair is complete, the incisions are closed with stitches or surgical tape and covered with a bandage.
The entire procedure usually takes about two hours.
After the Procedure:
- Recovery Room: You’ll spend a short time in the recovery room as the anesthesia wears off. This is an outpatient procedure, so you’ll be able to go home the same day.
- Sling: You’ll need to wear a sling for several weeks to protect the repaired tendon as it heals.
- Pain Management: You’ll be given pain medication to manage any discomfort. Icing your shoulder regularly will also help.
- Physical Therapy: Rehabilitation is a crucial part of your recovery. You’ll start with gentle, passive range-of-motion exercises and gradually progress to more active exercises and strengthening. Your physical therapist will be provided with specific protocols to guide your rehab and with this will create a personalized program to help you regain your strength and mobility.
Recovery Timeline:
- First few weeks: Focus on rest and protecting your shoulder. You’ll be in a sling most of the time.
- 6 weeks: In most cases you will stop using the sling at this point and will begin more active physical therapy.
- 3-6 months: You’ll continue with physical therapy to build strength and improve your range of motion. You can usually return to most of your normal activities during this time.
- 6 months to a year: Full recovery can take up to a year, especially for larger tears. With dedication to your rehabilitation program, you can expect a significant improvement in your shoulder function and a reduction in pain.
Take the Next Step Towards a Pain-Free Life
Living with shoulder pain doesn’t have to be your reality. If you’re in the San Francisco area and think you might have a rotator cuff tear, the experts at California Pacific Orthopaedics are here to help. Contact us today to schedule a consultation and learn more about how arthroscopic rotator cuff repair can help you get back to a life without limits.
