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Waterfall News

arm. At first, the pain may be mild and • Steroid injection - if rest, medication hospital stay and a quicker recovery
only present when lifting your arm and physical therapy do not relieve time than traditional open surgery
over your head, such as when reaching your pain, an injection of a local where larger incisions are made.
into a cupboard. Over time, the pain anaesthetic and cortisone around the
may become more noticeable at rest, tendons may be helpful. Cortisone
and it may no longer go away with the is a very effective anti-inflammatory
use of medication. You may have pain medicine, however, it is not effective
when you lie on the affected side at for all patients and should be used with
night. The pain and weakness in the caution in the case of diabetic patients.
shoulder may make routine activities
such as combing your hair or reaching The advantage of non-surgical
behind your back more difficult. treatment is that it avoids the major
risks of surgery. The disadvantages
It should be noted that some rotator of non-surgical treatment are that:
cuff tears are not painful. These • The size of the rotator cuff tear
tears, however, may still result in arm may increase over time. HTTPS://WWW.MOUNTSINAI.ORg/HEALTH-LIBRARY/SURgERY/SHOULDER-ARTHROSCOPY
weakness and other symptoms. • Future activity may need to be
limited to prevent further injury. Occasionally, a rotator cuff tear cannot be
WHAT TREATMENTS ARE repaired using this method and then the
AVAILABLE FOR A ROTATOR SURGICAL TREATMENT traditional open method will be used.
CUFF TEAR? Surgery is recommended if the
If you have a rotator cuff tear and you pain or your strength and mobility Surgery can be performed as a day
keep using your shoulder, despite do not improve with non-surgical procedure, however, sometimes
increasing pain, you may cause further methods. If you are very active and overnight stay in hospital may be
damage to the tendon or to the cartilage use your arms for overhead work or required. You will be discharged from
in the shoulder joint. A rotator cuff tear sports, surgical repair is suggested. hospital the day after surgery, provided
can get larger over time. Early treatment, your pain is well controlled. In the
however, can prevent further damage. Other indications that surgery immediate post-operative period,
may be a good option for you you will experience some pain and
The goal of any treatment is to include the following: discomfort in the shoulder. This could
reduce pain and restore function. • Your symptoms have lasted six to last up to six weeks, however it should
There are several treatment options 12-weeks despite physiotherapy; improve after the first two weeks.
for a rotator cuff tear based on your • You have a large tear (more
age, activity level, general health, than 3cm) and the quality of the You will be required to wear an arm
and the type of tear you have. surrounding tissue is good; sling for the first six weeks to protect
• You have significant weakness and the repaired tendons from any
NON-SURGICAL TREATMENT loss of function in your shoulder; damage. This also helps with lessening
In some patients, non-surgical • Your tear was caused by a recent injury. the pain. Driving a vehicle is not

treatment can relieve pain and recommended in the first six weeks.
improve function in the shoulder. Surgery to repair a rotator cuff tear is
performed in hospital, usually under REHABILITATION AND
Nonsurgical treatment options general anaesthetic. The tendons RECOVERY AFTER SURGERY
may include the following: are repaired by stitching the tendon A physiotherapist will see you in
• Rest. edges back down onto the bone of the hospital after the surgery to start your
• Activity modification - avoiding head of the humerus using anchors. rehabilitation and teach you exercises
activities that cause shoulder pain. which you will need to do in the post-
• Non-steroidal anti-inflammatory The majority of rotator cuff tears can operative period. It is essential that
medication - medication such be repaired using a minimally-invasive you visit a physiotherapist regularly
as Voltaren and Naproxen can ‘keyhole’ technique. Keyhole surgery, in addition to completing a home-
reduce pain and swelling. also known as arthroscopy, allows the based rehabilitation programme daily.
• Physiotherapy - specific exercises under surgeon to look inside the joint using A physiotherapist and biokineticist
the guidance of a physiotherapist can a camera, and repair any structures play a vital role in ensuring that your
restore movement and strengthen your through very small incisions. Minimally- shoulder returns to normal function.
shoulder. Strengthening the muscles invasive surgery typically causes less
that support your shoulder can relieve injury to surrounding tissues, resulting You can expect a complete recovery
pain and prevent further injury. in less post-operative pain, a shorter to take more than six months.

22 Waterfall Issue 9 2020