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FEBRUARY 28, 2009
Outlook Is Good For Rotator Cuff Repairs


A rotator cuff repair used to mean the end of weekend tennis matches. Tearing these muscles left the shoulder weak. Today, tearing the rotator cuff muscles is not as big a problem because of better rehabilitation programs and much better surgery. In fact, if you have rotator cuff surgery, even if you tear the muscles again, you may not feel any pain and your shoulder will still function fine.

The small rotator cuff muscles in the shoulder are not meant to function under any stress with the arm above parallel to the ground, for example, when you hit a tennis serve or an overhead. If the shoulder joint is continually stressed with the arm in this overhead position, the rotator cuff muscles begin to stretch out. This allows the head of the joint to become loose within the shoulder socket.

When your arm is higher than parallel to the ground, the tendon of the long head of the biceps muscle becomes impinged, causing shooting pain down through the tendon of the shoulder into the connecting muscle. Most (3 out of 4) rotator cuff problems can be cured with physical therapy. Those who don't respond to PT require surgery to repair the shoulder joint.

Rotator cuff surgery appears to have long-term benefits to shoulder health, according to a study presented at the 2009 American Orthopaedic Society of Sports Medicine Specialty Day in Las Vegas this month. Initially, doctors from the Hospital for Special Surgery in New York City tested 15 patients 3 years after rotator cuff surgery and found that those who had a recurrence were doing well, reported lead author Christopher Dodson, MD, an orthopedic resident.

An average of eight years after surgery, ultrasound tests of 11 patients indicated that those who had a recurrent rotator cuff injury had less pain, and better function and strength, than they did before the original repair. The recurrent tears grew in size over the years, but were painless and did not affect function. None of the patients needed further treatment or surgery, and none experienced any persistent shoulder pain.

  
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