The group of muscles and tendons surrounding your shoulder joint is called the rotator cuff. Their job is to keep the head of the upper arm bone, the humerus, in the shoulder socket, the glenoid, and allow you to move your shoulder in many different directions.

If irritated or damaged, you might experience pain or reduced range of motion. The biggest problem with these rotator cuff injuries is that they don’t heal by themselves. This is why you may need treatment or even rotator cuff surgery.

Still:

• What does this surgery look like?
• How to recognize if you need surgery?
• What should you do before the surgery?
• How long is the recovery?

Here are the answers to some of these questions!

How Does a Rotator Cuff Tear?

The most common cause of a rotator cuff (musculotendinous cuff) tear is the slow wearing of tissue over a long period of time. This often happens to those who do heavy lifting or engage in repetitive overhead activities daily. So, this is where the majority of rotator cuff tears come from.

Of course, a tear can occur as a single incident, especially when met with unexpected weight or fall accidents.

Before having rotator cuff surgery, you must get a proper diagnosis. So, if you believe you’ve been in either of these two scenarios, you might start examining your symptoms.

What Are Rotator Cuff Symptoms?

You must examine the symptoms to determine whether your rotator cuff is injured.

• The first and most common symptom is a recurring pain in the shoulder and most commonly in the mid-upper arm. Most commonly, it would recur while engaged in certain everyday life activities and with certain shoulder positions.
• It is also likely that the pain will hinder you from sleeping on the injured shoulder. 
• Your arm may have limited range of motions and/or weakness.

If all of these symptoms are persistent after nonoperative modalities, surgery is likely needed. Still, this is not always the case. Speaking of which…

When to Not Have Rotator Cuff Surgery? 

Surgery is not the best option when you have a partial thickness or complete non-retracted rotator cuff tear. According to some surveys, failure after surgery is common in these scenarios, and you have about a 60% chance to re-tear the tendon. So, should you have surgery or not? The answer is never easy, but it’s always safest to ask a professional.

When Should You Have Rotator Cuff Tear Surgery?

The majority of experts agree that the clear signs that the surgery is necessary are:

• Your symptoms last for months (usually 6 to 12 months).
• The tear is large (bigger than 3cm).
• The weakness in the arm is significant.
• The tear was caused by an acute injury that occurred recently.

If all of these align, chances are that your doctor will recommend surgery; however, you should not embark on surgery without a doctor’s recommendation.

What Is Rotator Cuff Surgery Like?

During rotator cuff surgery, tendons are secured down to their original site on the humerus by a series of very strong sutures and suture anchors - which hold the sutures into the bone. If it’s a minor tear, you may only need a debridement, or a “cleanout” procedure.

As far as the procedure is concerned, it takes about two hours depending on what needs to be done. After this, you’ll likely spend one to two hours in the recovery room. The majority of patients get discharged home soon after that.

One more thing worth mentioning is that if you do have to go to surgery, the rotator cuff surgery success rate is more than 95% for minor tears. The success rate is still greater than 70%, even for two tendon tears.

What Is the Rotator Cuff Surgery Recovery Time?

The tendon may take six to eight weeks to heal, during which time you have specific limitations to protect the repair (sling and no lifting, for example). The total recovery, however, depends on the size of the tear and how quickly you complete physical therapy. 

Other than just experiencing shoulder pain, some reported elbow or wrist symptoms after the surgery. This is a usually a result of being in a sling, so doctors recommend elbow range of motion a few times daily. Still, this is something that you should check with your surgeon if you experience to make sure you have the proper treatment.

What Are the Side-Effects of Waiting Too Long for Rotator Cuff Surgery?

As we’ve mentioned, there are some scenarios in which surgery is not the best option. It’s good to wait until you have all the facts and a doctor’s opinion. Surgery is indicated, when you have continued pain, weakness, and reduced range of motion despite doing physical therapy, medications, and other nonoperative modalities. If you wait too long, the rotator cuff tear may become larger, which is more difficult to repair, and the muscles themselves may become atrophic (or shrink) and their function notably reduced. In very severe, long-standing situations you may develop advanced arthritis that requires replacement-type procedures. 

Ideally, it would be best to be evaluated by a orthopedist within six weeks from an acute injury (the sooner the better). This gives you plenty of time to get it examined and diagnosed. This way, you also stand the best chance of avoiding atrophy of the muscle and tendon.

If surgery is deemed necessary, without action, the musculotendinous cuff will only get worse.

Wrap Up

In the end, since the rotator cuff will not heal without surgery, there’s no reason to delay, postpone it, or have second thoughts. The success rates are high, and the entire procedure lasts less than three hours. So, if your doctor has diagnosed a tear and recommended rotator cuff surgery, you should go through with it as soon as possible.

If you are injured, your safest bet is to find an expert in rotator cuff surgery at the Orthopedic Institute of New Jersey for an evaluation and discussion of the best treatment option for you.