Diagnosis? Learn more about this topic here: http://www. Theshouldercenter. Com/shoulderpain/2013/shoulder-surgery/spur-acromioplasty-impingement/ and http://theshouldercenter. Com/rotator-cuff-tear. Htm it's important to have a clear diagnosis and cause for your shoulder pain before considering surgery.
Two different things. Repair of the torn rotaotr cuff, to use sutures to close the gap in the torn cuff which could be done in three main ways. Generally, it implies removal of a small piece of the surface of the bone (acromion) that is in contact with a tendon causing, by friction, damage to the latter tissue.
Short answer. A rotator cuff repair takes the torn tendon and reattaches it to the bone. An acromioplasty involves reshaping the shoulder blade bone above the shoulder to either create more space or to remove bone spurs. An acromioplasty is not always necessary or recommended. A better longer answer can be found here: http://orthoinfo. Aaos. Org/topic. Cfm? Topic=a00406.
Shoulder Surgeries. Both of these are shoulder surgical procedures. A rotator cuff repair is a procedure performed to re-attach or repair one or more of the four rotator cuff tendons of the shoulder. An acromioplasty is a procedure in which the undersurface of the acromion (a part of the scapula) is resected to minimize contact on the underlying rotator cuff. These procedures may be performed arthroscopically.
Surgery. Rotator cuff repair is simply the surgical repair of a torn rotator cuff tendon and acromioplasty refers to surgical removal of a portion of the acromion (an inferior prominence of the anterior acromion) to create more room for the rotator cuff.
Repair and remodel. Rotator cuff disease involves the tendon, bursa and bone. The final stage in the process is tearing of the rotator cuff tendon. In order to repair the tendon and prevent further damage, all three must be addressed. The inflamed bursa is removed to identify and mobilize the torn rotator cuff tendon, which is secured to the bone (repair) and excess bone/spurs are removed (acromioplasty).
Different parts. An acromioplasty is when bone on the acromion, which is above the rotator cuff, is shaved down. This is typically done if there is a large bone spur coming off the acromion. The rotator cuff attaches to the humerus, and the muscles of the rotator cuff pull on the cuff to elevate the shoulder. If the cuff is torn, it is repaired back to the humerus.
Shoulder. A rotator cuff repair is a fixation of a torn tendon. An acromioplasty is the shaving of a bone spur which maybe impinging on the rotator cuff. This also provides more room for the rotator cuff to function.
Repair vs clean-up. A rotator cuff repair involves finding the torn end of the rotator cuff and securing it to the bone. An acromioplasty involves removing bone spurs from the acromion. Both procedures are commonly done together if the rotator cuff is torn. Inflamed and hypertrophic bursal tissue is also removed with both procedures.
Complex. Not easy to answer as many surgeries are possible. Ask your surgeon which one they are planning and what it entails.
Reattachment of RC. In my hands 99% of rotator cuff repairs are performed arthroscopically (through small incisions with the help of a fiberoptic camera). Patients go home the same day and full recovery can take 3-12 months. Each repair is different and depends on the type of tear, but generally the rotator cuff tendon which has torn loose from the humerus (shoulder) bone is reattached using a combination of sutures.
Many Techniques. There are many techniques and widely varying healing rates depending on several factors. Learn more here:http://www. Theshouldercenter. Com/video-how-to-choose-a-surgeon-for-your-rotator-cuff-repair. Htm.
It depends. This depends heavily on the size of the tear, associated injuries, type of repair, and your surgeons preferred protocol. The best answer is to discuss it in detail with your surgeon and physical therapist. In general, initial rehab will be directed at reducing pain and swelling, then restoring range of motion, followed eventually by a gradual outlined strengthening program.
Rotator cuff. The rehab is slow. It can take up to 6 weeks just for the initial healing with limited motion of the shoulder. The next phase involves regaining active shoulder motion and flexibility. The last phase in recovery is strengthening. The whole process can take 3-6 months.
Slowly. Rotator cuff repair requires patience. The repair requires time to heal but you need to keep the joint from stiffening. After the repair your surgeon will start you on passive range of motion exercises, when he or she feels you are ready, followed by more active use of the arm. A good physical therapist will keep you limber and plan you program.
Cuff repair rehab. Tough to answer in 400 characters. However, goal of rotator cuff repair is to get torn tendon to heal to the proximal humerus. Best results correlate with healed repair. Therefore, proceed slowly and carefully. If rehab is aggressive, risk of repair not healing. Expect 6+ month recovery.
Slow but steady. Recovery and rehab will vary widely depending on tear type, size, associated injuries, pre-operative function, post-operative goals, and repair type. In general, early treatment involves protection in a sling for 4-6 weeks and gentle range of motion exercises with eventual progression to strengthening exercises. Full recovery typically takes at least 3 months, but often can take 6-12 months.
Continue rehab. Need to have physical therapy for several weeks. That is what I had done on my shoulder.
Timing. It takes 6 weeks for the tendon to heal to the bone. During the healing phase, it is important to avoid any stress on the repair. Active shoulder range of motion should be avoided. Once the repair is healed therapy is begun first to restore range of motion, then for strengthening. Depending on the size of the tear, it may take 6-18 months for full restoration of function.
It depends. Not all tears are the same size and not all repairs heal att eh same speed. If you have a partial thickness or small full thickness tear you can do some strengthening with light weights, but a full thickness tear, especially a moderate to large repair needs to be protected. Your surgeon should be the one to determine whether you are ready to do weight bearing exercises or not.
No. Rotator cuff repair implies repair of soft tissue like tendons/muscle attachments and it would unduly stress the repair if you did any weight bearing exercises. It is generally recommended that you wait about 12 weeks before stressing the repair.
Not recommended. I would not advise weight bearing exercises for at least 10 weeks. I would want to know what you exactly mean but no resistance or "chicken winging" shoulder for at least first 6 weeks. Can start light isometrics (pushing against object) at 7-8 weeks. Strengthening usually not begun till 12 weeks which is typical length of bone scarring to tendon.
Neck? Pain in the shoulder blade is commonly referred from the neck. In the setting of pain following a cuff repair, it may also be related to use of scapular muscles in compensation for poor functioning rotator cuff. Try a deep-tissue massage focusing on your sore shoulder blade. Perhaps some stretching exercises for the neck may help. Some patients find a tens helpful. Ask your therapist.
Continue therapy. It is not uncommon to have pain for several months after a rotator cuff repair. At first the pain is due to the surgery itself. Then there is pain when beginning range of motion. Finally, there is muscle pain from strengthening. All of these stages are normal and when you progress through them you will feel better. Be patient because it will take several months.
I have had 2 rotator cuff repair surgeries and each time during pt it was retorn. Now its worse than ever. Now what!
Some don't heal. Some cuff tears are irreparable for a variety of reasons. It might surprise you to find out that a high percentage of large cuff tears either do not heal or re-tear. If it gave way during therapy 2 times, then it was not likely to heal in the first place. Symptomatic care is best for now with therapy and the occasional injection, reverse shoulder replacement if things worsen.
Recurrent cuff tear. If you have had two failed rotator cuff repairs, your options are 1. Tendon graft, either autograft or allograft. 2. Tendon transfers. 3. Reverse total shoulder replacement. 4 shoulder arthrodesis.
I am four weeks post op rotator cuff repair...Pt is extremely painful. When does that ease up? I don't know how much more I can take.
Painful surgery. But after 4 weeks should ease up, check with your doctor he may give some special pain medication or muscle relaxant. Some time this could be a sign of complication check it out.
Would slow down. I am not a fan of early pt. Recent study done by cuff et al. That won the neer award (prestigous shoulder research award) showed that early therapy lead to higher failure rates. At 4 weeks the cuff is still healing...In fact up to 12 weeks. I don't like when therapy is painful as can cause capsultis and actually slow overall progress. I would have therapist slow down or back off. Itll improve.