How do you know if you need Rotator Cuff Surgery?

As a physical therapist working with clients with many shoulder injuries and conditions, this is a question I field quite often. What I see most often in a client with shoulder pain is a referral from their physician for shoulder pain. Often, we focus on rotator cuff rehabilitation.

The rotator cuff is made up of four muscles. These individual muscles combine at the shoulder to form a thick "cuff" over this joint. The rotator cuff has the important job of stabilizing the shoulder as well as elevating and rotating the arm. Each muscle originates on the shoulder blade, or scapula, and inserts on the arm bone, or humerus. Injuries and inflammation to these muscles can cause pain and decreased range of motion. A torn rotator cuff muscle can severely limit movement and strength in the shoulder joint.                                

As a physical therapist, I help the patient restore as much shoulder function as possible, focusing on scapular stabilization, rotator cuff strengthening, and postural correction. Many times this is successful and the patient is able to go on living their life without limitation. At other times, they continue to have both pain and functional limitations, leading them to consult with both their primary care physician as well as an orthopedic surgeon.

This week, I sat down with Joseph Hance, MD, Orthopedic Surgeon with Bay Street Orthopedics, to discuss this question: How do I know if I need Rotator Cuff Surgery?

Q:           What indications lead you to recommend Rotator Cuff Surgery for your patients?

Q:           What diagnostic tests help you make this recommendation?

Q:           What options exist for someone with a Rotator Cuff tear? Conservative? Non-Conservative?

Q:           What surgical techniques are possible for Rotator Cuff Repair(RCR)? Indications for them?

Q:           In some cases, the Rotator Cuff is irreparable. What then?

Q:           Describe recovery timeframes for someone with a RCR? Variables that affect this?

Q:           Generally, what type of an outcome can some expect following RCR?

Clearly, answering this question involves many factors which need to be considered. Consultation with your primary care physician and ultimately with an orthopedic surgeon will give you considerable information and options to help you make the decision that is best for you.

Joseph W. Hance, M.D. is the senior practicing orthopedic surgeon with Bay Street Orthopedics in Petoskey, Cheboygan, and Charlevoix. He graduated from Wayne State University School of Medicine in 1977 and completed his internship and a four year orthopedic residency at William Beaumont Hospital in Royal Oak, Michigan. Dr. Hance is certified by the American Board of Orthopedic Surgeons.

Dr. Hance practices general orthopedic surgery with special interests in joint replacements, arthroscopy, and rotator cuff repair of the shoulder. Dr. Hance is on active staff at McLaren Northern Michigan in Petoskey, McLaren Cheboygan Campus in Cheboygan, and Charlevoix Area Hospital in Charlevoix.