Your rotator cuff is the group of tendons in the shoulder joint that provide support to your shoulder and enable the shoulder’s wide range of motion. Major injury or wear over time can cause these tendons to pull away from the humeral head (or your upper arm bone) resulting in a rotator cuff tear. The rotator cuff is the most commonly torn structure in the shoulder joint.

Rotator cuff tears cause severe pain, weakness of the arm, and crackling sensation when moving the shoulder in certain positions. There may be stiffness, swelling, loss of movements, and tenderness in the front of the shoulder.

In almost all cases, conservative non-surgical treatment is the first option. These methods include:

• Rest
• Using a shoulder sling
• Pain medications or injections to help decrease inflammation
• Exercise/Physical therapy

Our goal is to achieve optimal shoulder function with conservative treatments. However, the constant presence of pain is the main indication of surgery. You should consider rotator cuff surgery if you experience the following:

• Failure of conservative treatments: conservative treatments do not relieve the pain or restore shoulder function.
• Shoulder pain interferes with your everyday activities: simple activities like getting dressed, fixing your hair, or even sleeping become difficult because of the pain.
• High function demand placed on your shoulder: your job or activity level demands high function of your shoulder joint.
• Severity of the tear: a large tear may necessitate surgery.

Rotator cuff repair may be performed by open surgery or an arthroscopic procedure. Should surgery be necessary, post-operative physical therapy plays a vital role in fully regaining strength and range of motion.

Rotator cuff tears are common, but surgery is not always indicated. Conservative treatments can help achieve shoulder function and strength. When conservative treatments fail to provide relief and pain is interfering with your everyday activities or work, then you should consider rotator cuff surgery.

Milan M. DiGiulio, M.D. offers comprehensive orthopedic care for you and your entire family, specializing in Sports Medicine and arthroscopic surgery of the shoulder and knee. Dr. DiGiulio performs over 200 arthroscopic shoulder and knee surgeries each year, using the most advanced surgical technology. Dr. DiGiulio is an advocate of non-invasive, non-surgical treatment options such as Physical Therapy and Orthobiologics.