Rotator Cuff Tears

How do I know if I might have a tear?

Rotator cuff tears typically cause pain when one reaches overhead. They also cause pain at night. The pain generally starts at the outside of the shoulder and radiates down the outside of the upper arm toward the elbow. If you have this type of pain and it does not go away after 3-4 weeks, it is probably a good idea to have a specialist look at your shoulder. In some cases, tears may be prevented by early treatment.

What might have caused the tear?

Most people have a bone spur under their shoulder blade that rubs a hole in the rotator cuff over time. Only a small percentage of patients tear their rotator cuffs in sudden injuries. Usually the spurs wear the rotator cuff down over a long period of time. Some people are born with these spurs, and the spurs get bigger as one gets older. If you have one of these spurs, you are at risk for tearing your rotator cuff. The spurs can usually be detected with properly positioned X-rays. Early removal of the spurs before the rotator cuff is torn can prevent the need for a much more involved procedure later.

How long does the procedure last?

The operation to fix a torn rotator cuff generally takes between 60 and 90 minutes in our hands. If there is not a tear, removal of the bone spur takes only 30 minutes.

Will I have to go under general anesthesia?

Not necessarily. The Nashville Knee & Shoulder Center is one of a select number of centers where rotator cuff surgery can be performed without general anesthesia. Instead, patients normally receive a nerve block combined with a “twilight” anesthesia to relax the patient. Avoiding general anesthesia markedly reduces the risks of surgery.

Will I have to stay in the hospital overnight?

No. Rotator cuff surgery is now performed on an outpatient basis.

What will the aftercare be?

You may remove your bandage 48 hours after surgery. After the initial bandage has been removed, you may shower. If the rotator cuff has been repaired, you will be in the sling for one month. If the spurs are removed before the rotator cuff is torn, you will only have to wear the sling for a couple of days.

How long will I be in physical therapy?

If the rotator cuff had to be repaired, you will attend physical therapy on a regular basis for 2-4 months after surgery. Therapy will begin 2-4 days after surgery. In cases where a repair is not necessary, patients can usually be instructed to perform their exercises at home without the need for formal physical therapy.

How long will I be out of work?

You can expect to be out of work for at least 2 weeks after surgery to repair the rotator cuff. If your work requires heavy lifting, you may be unable to perform your usual job for several months. In cases where the spurs are removed before the rotator cuff is torn, you can expect to return to work after one week and will be able to return to heavy lifting between 8 and 16 weeks after surgery.

How long until I can resume normal activities?

After a rotator cuff repair, most patients can resume normal activities (except for heavy lifting and overhead work) at about 6 weeks after surgery. Three weeks generally suffice in patients who do not have a tear.

How long before I can throw or play sports?

Generally, six months are required before athletes can return to sports after a rotator cuff repair. After bone spur removal, 8 to 16 weeks are needed to return to sports.