What is rotator cuff?

A rotator cuff is a group of four tendons and muscles that support your arm at the shoulder joint. They allow you to move your shoulder up, down, backwards, forwards, and to rotate it and, help keep your shoulder joint in its socket.

Rotator cuff damage can occur to any or all of the rotator cuff components due to injury, chronic overuse, or gradual aging. A torn rotator cuff can be confused with other shoulder injuries such as a frozen shoulder. Your doctor will be able to offer a diagnosis. The symptoms of rotator cuff damage include:

• Shoulder pain and discomfort that can radiate down your arm.
• Weakness when you lift or move your arm from the shoulder.
• Limited shoulder movement. You may be unable to move your shoulder fully.
• Difficulty doing everyday tasks such as getting dressed or, combing your hair.

You will likely receive general anaesthetic before rotator cuff surgery.

There are many different types of surgeries for rotator cuff injuries, including:

• Arthroscopic tendon repair - a tiny camera (arthroscope) and instruments are inserted through very small incisions to reattach your torn tendon to the bone. It is usually an outpatient procedure and does not require an overnight stay in hospital.
• Open tendon repair - a larger incision to your shoulder skin is made to reattach the damaged tendon to the bone. It is generally used for large tears and typically requires a longer recovery than arthroscopic surgery.
• Bone spur removal – the removal of an overgrowth of bone that is irritating your rotator cuff. It can be performed by arthroscopic or open surgery to remove the bone spurs from the underside of your acromion. It aims to stop your rotator cuff tendon from rubbing against the bone.
• Tendon transfer – if your torn tendon is too damaged to be reattached to your arm bone, then your surgeon may decide to use a nearby tendon as a replacement.
• Shoulder replacement – if your rotator cuff is extensively damaged, shoulder replacement surgery may be required.

Your orthopaedic surgeon will give you advice on which type of surgery is best for you.

Rotator cuff repair surgery is used to treat a torn or impinged rotator cuff including:

• A rotator cuff tear – a common injury when a tear occurs to one or more of your rotator cuff muscles and tendons. The tear can be partial or complete depending on the degree of damage to your tendon. It can cause shoulder pain and weaken your shoulder. The tear may happen suddenly after an injury, such as a fall or, it can develop gradually through wear and tear.
• Subacromial impingement – also known as tendinitis, tendonitis, trapped tendon or bursitis. It occurs when your rotator cuff tendons become irritated and inflamed as they pass through the narrow space at the top of your shoulder and causes shoulder pain. Bony spurs or arthritis may make it narrower. Injury or loss of strength of your rotator cuff muscles may also result in impingement. A subacromial impingement have occur from an injury, overuse of your shoulder (such as swimming or tennis) or wear and tear with age.
• Calcific tendonitis –calcium builds up in your rotator cuff tendon and causes an increase in pressure in your tendon. It can be extremely painful and, may cause subacromial impingement.

Rotator cuff surgery aims to provide pain relief and improve the movement, strength and power of your shoulder.

There is a risk of complications after rotator cuff surgery, as with any surgical procedure, including:

• Nerve injury
• Deltoid detachment – during open surgery this shoulder muscle is detached and stitched back into place. It’s important to protect this area following surgery.
• Stiffness – often improved with exercise.
• Tendon re-tear - larger tears have a higher risk of re-tear. Patients with a re-tear do not usually have the pain or decreased shoulder function as that before their surgery, so repeat surgery may not be required.

If you decide to pay for your treatment, Ramsay offer an all-inclusive Total Care package, where a single one-off payment at a pre-agreed price, delivering direct access to all the treatment you need for complete reassurance. You can also spread the cost of your treatment with finance options available.

Rotator cuff surgery may be covered by your medical insurance policy. We advise you to check directly with your insurance provider and get written confirmation before commencing treatment.

Your recovery from rotator cuff surgery will depend on the type of surgery you have had and your health before surgery. You may need to take several weeks off work. Your surgeon will be able to advise you on the timings of what you can and cannot do.

Your physiotherapy team will develop an individual rehabilitation plan to gradually build up exercises that will help strengthen your shoulder and regain its full movement.

Most people have a sling for around six weeks to protect the healing of their tendons.

Recovery from arthroscopy is often faster than recovery from open surgery.

A complete recovery from rotator cuff surgery usually takes six to twelve months.

At Ramsay Health Care we provide you with the support you need before, during and, after your rotator cuff shoulder surgery, so you can recover as quickly as possible and return to the activities you love.

We have friendly and professional staff including expert orthopaedic surgeons, well-equipped hospitals with advanced diagnostic equipment and, excellent physiotherapy services to aid rehabilitation. We aim to provide you with the very best of care throughout.