You probably don’t give much thought to everything your shoulders do until one of them starts to hurt or you realize you can’t do the things you enjoy because your shoulder is weak or hurts.
In many cases, shoulder pain is due to a tear in the rotator cuff. In this video, San Diego Health host Susan Taylor talks with Brian Rebolledo, MD, an orthopedic surgeon at Scripps Clinic Torrey Pines, about rotator cuff injuries and treatment.
The rotator cuff is a group of muscles around the shoulder that help support shoulder function and stability. Tears in the rotator cuff can be painful and limit your ability to use your shoulder as you normally would.
According to Dr. Rebolledo, there are two main causes of rotator cuff injuries. One is trauma, such as a skiing accident or falling from a bike.
“The other possibility is that over time the rotator cuff can degenerate,” he says. “As we get older, we’re a little bit more at risk for the tendon quality and integrity to change, and if it does, we’re a little more susceptible to a rotator cuff tear.”
Repetitive motions, such as throwing a ball or swinging a tennis racket, can also weaken the rotator cuff.
Pain is usually the first symptom of a rotator cuff tear, often followed by a loss of strength or ability to fully use the shoulder.
The first step in diagnosing a rotator cuff injury is providing your doctor with a thorough history of how long you have been having pain, which activities are most painful and any trauma that may have contributed to it. Your doctor will likely have you do various movements to help pinpoint the problem. In addition, they may order an imaging exam, such as an MRI or ultrasound to confirm the tear.
Most rotator cuff tears require surgery to repair. This used to be a long and often painful process, but newer minimally invasive surgical techniques have made rotator cuff surgery less invasive and painful with a shorter, easier recovery time.
Technology also has advanced to offer relief to patients whose severe rotator cuff tears can’t be surgically repaired.
“We have a new FDA-approved device that’s known as a subacromial balloon spacer designed for a specific type of patient who has an irreparable or massive rotator cuff tear, one that we’re really concerned about re-tearing over time,” says Dr. Rebolledo. “It is essentially a saline-filled balloon that fills up the space where the rotator cuff is deficient, and that can provide better support and stability and usually better pain relief over time.”
The balloon implant dissolves in approximately one year, and the theory is that the shoulder will stabilize in a new position that maintains pain relief even after the balloon dissolves. Based on data from almost 29,000 patients, the balloon implant can provide at least five years of relief. Because it is filled with saline, the risks of complications are low.
Like most types of rotator cuff procedures, this is an outpatient treatment. Most patients go home the same day. Typically, patients work with a physical therapist to regain function and learn proper ways to move. Most patients can return to full activities within three to six months.
“If you’re having pain in the shoulder, and you feel that your function and even sleep are starting to become affected, you may have a rotator cuff injury,” says Dr. Rebolledo.
“If this has been sustained or seems to be progressive it’s definitely time to see an orthopedic surgeon to have that evaluated. There are a lot of new devices and treatments that really make a big difference for patients to get back to the things that they love.”