Rotator cuff what kind of doctor

If you have a rotator cuff tear, it's important to seek treatment as soon you can because with time, some rotator cuff tears can become too big to fix and may require a more complex surgery. Non-surgical treatment may be best if you just want relief from pain and the ability to function again. If you use your shoulder for strenuous work or athletics, you may be a better candidate for surgery. If non-surgical treatment does not work for you, surgery to repair the rotator cuff may be recommended.

Patients who had a recent trauma that caused the tear may be candidates for surgery right away because it can improve the chances for healing. There are a few options to surgically repair a torn rotator cuff, and U-M surgeons are expert in all of them:. The goal of any of these surgeries is to attach the tendon back to the bone where it tore off, to keep it there while it heals and to help you maintain good shoulder health.

As part of the University of Michigan Comprehensive Musculoskeletal Center, we collaborate with multiple disciplines, including:. Our integrated, multidisciplinary approach to patient care enables us to develop an individualized plan for your treatment. You're about to make an important decision, and we want to help you make a good one.

Our staff will be glad to talk with you about your options and how we can help. The condition can also be caused when patients have loose ligaments in their shoulder — whether the looseness is their anatomy or a result of repetitive overhead motion. Those who play volleyball, tennis, or swim sometimes have stretched shoulder ligaments.

Shoulder separation is a condition caused solely by loose ligaments — the bones remain in place, but the loose ligaments create a feeling of instability and weakness in the shoulder.

As detailed above, some specific sports and occupations can increase the risk of problems with the ligaments in the shoulder. Physical therapy and modifications to your activities can help minimize the symptoms. Physical therapy can also help strengthen the shoulder to improve stability. Anti-inflammatory medications and injections can also help to relieve the swelling and pain. Surgery is sometimes necessary to repair damaged ligaments, allowing them to hold the shoulder in place again.

At MOA, we see consistently positive outcomes for shoulder surgeries. The ball joint of the humerus upper arm is held in place by the labrum — a rubber tissue attached to the shoulder socket to help keep the joint stable. A SLAP lesion superior labrum, anterior to posterior is a tear above the middle of the shoulder socket. Tears to the labrum can occur from a sudden injury or can wear and tear as we age.

Injuries that can cause a labrum tear include falling on the shoulder or arm, a direct hit to the shoulder, reaching overhead rapidly or a sudden pull. Some athletes, like weightlifters or throwing athletes, can see these types of injuries as a result of a repetitive motion that wears down the labrum. A labrum tear causes pain, especially when reaching overhead. It may create a feeling of instability and loss of strength, along with a decrease in your range of motion.

Some people experience a grinding sensation or popping and locking in the joint. Physical therapy may help strengthen the muscles in the rotator cuff, while anti-inflammatory medications can help relieve the symptoms. For a labrum tear, surgery is minimally invasive. While therapy is always needed after surgery to regain your range of motion and strength, there is minimal downtime.

Shoulder Replacement. Shoulder replacement surgery is not as conventional as hip or knee replacements. However, it is an effective way to treat severe pain, swelling, weakness, and loss of range of motion if these symptoms have not responded to more conservative treatments. People who have arthritis, rotator cuff tears, severe fractures and more may benefit from shoulder replacement surgery.

Here, you will discuss your medical history and have a full physical examination. As there are several different procedures for a shoulder replacement, you and your doctor must work together to ensure you understand your options. For patients who had a previous shoulder replacement that failed, have an incredibly severe rotator cuff tear or debilitating arthritis, a reverse shoulder replacement may be an option. In a reverse shoulder replacement, the ball and socket are switched — a plastic socket is attached to the humerus, and a metal ball is attached to the shoulder bone.

The reverse shoulder replacement means the patient can lift the arm with their deltoid muscle, not the torn rotator cuff. At MOA, we have ample experience with shoulder replacement and can help you through the process. We understand that it is a huge decision and make sure you know all of the risks and benefits of the surgery before we proceed. We take pride in the education and experience that each of our doctors holds.

From your initial appointment to the conclusion of your treatment, we strive to keep you informed and active in the decision-making process. We also seek to be minimally invasive in our treatments, reducing the amount of time a patient is in the hospital. With many of our surgical procedures, patients are home the same day of surgery. Topics: orthopedic surgery , Treatments , shoulder pain.

Bruceton Mills, WV It may hurt or be impossible to do everyday things, such as comb your hair, tuck in your shirt, or reach for something. You may have pain during the night and trouble sleeping. To diagnose a rotator cuff disorder, doctors ask about any shoulder injuries or past shoulder pain. They also do a physical exam to see how well the shoulder works and to find painful areas or activities.

Moving your arm in certain ways can help a doctor learn about the condition of the rotator cuff. You may have an X-ray to check the bones of the shoulder. If the diagnosis is still unclear, the doctor may order an imaging test, such as an MRI or an ultrasound. It is important to treat a rotator cuff problem. Without treatment, your shoulder may get weaker and you may not be able to lift up your arm.

For most rotator cuff disorders, doctors recommend these steps first:. The doctor may also suggest physical therapy. Physical therapy can reduce pain and help make your shoulder stronger and more flexible. In physical therapy, you learn exercises to stretch and strengthen your shoulder. After you learn the exercises, you can do them at home. It is important to give treatment time to work. It may take from a couple of weeks to several months to get good results.

If other treatments don't help, your doctor may give you shots of steroid medicine in the shoulder. The shots probably don't cure rotator cuff disorders. But they can help relieve pain and inflammation so you are able to do exercises to strengthen the shoulder. The shots may also help your doctor find out if your shoulder pain is from your rotator cuff. If a steroid shot near the rotator cuff relieves your pain, even if the pain comes back later, it means the rotator cuff—not some other shoulder problem—is causing the pain.

Most rotator cuff disorders aren't treated with surgery. But doctors may do surgery if a rotator cuff tendon is torn or if several months of other treatments have not helped. Health Tools help you make wise health decisions or take action to improve your health. In a rotator cuff disorder, tendons that make up the rotator cuff get squeezed and rub against bone.

They become damaged and irritated. This causes bleeding and inflammation. The tendons can develop scar tissue, which is not as strong and flexible as normal tendon tissue.

Over time, the tendons get weaker and less flexible. Eventually, they can tear. Normal wear and tear and overuse cause most rotator cuff problems. A rotator cuff disorder causes pain and weakness in your shoulder. It may be uncomfortable or impossible to do everyday activities, such as combing your hair, tucking in your shirt, or reaching above your head. Most often, you will feel the pain on the side and front of your upper arm and shoulder.

You may have pain during the night and have trouble sleeping on that side. Pain is almost always worse when you make overhead movements. Because of the pain, you may try not to use your arm. And that can cause even more weakness and stiffness in the shoulder. The amount of pain usually depends on how much damage there is:.

Sometimes the pain isn't directly related to the amount of damage. For example, your rotator cuff may have minor damage, but strength and the loss of range of motion may be severe because it's too painful to move in certain ways. This is especially true if you normally make a lot of overhead movements. In tendinitis inflammation in the tendon , the pain usually starts gradually, over the side of the shoulder and the upper arm.

Over time, the pain may get worse or you may have constant pain. In some cases, this is because you actually have one or more small tendon tears. Some people also have tendinitis in other parts of the shoulder. And some people have neck pain from using other muscles to help move the shoulder. You can have a complete tear without symptoms, especially if you are an older adult who is not very active. In rare cases, shoulder pain may be a sign of a more serious problem with your heart or lungs.

The rotator cuff is a group of four tendons. These tendons connect the main muscles of the shoulder to the upper arm. The tendons and muscles stabilize the shoulder joint so you can raise and rotate your arm.

Every time you raise your arm above your head, the upper tendon glides under the upper end of your shoulder blade. Sometimes the shoulder blade is rough or abnormally shaped and rubs or scrapes the tendon. Over time, this can cause tiny tears and bleeding. When these tears heal, the scar tissue is weaker and less flexible than normal tendon, so the whole rotator cuff gets weaker.

The weaker the tendon becomes, the greater its chances of tearing. Without treatment, this cycle of inflammation, wear and tear, and limited use can lead to other shoulder problems, such as stiffness or frozen shoulder.

Activities that require repeated overhead arm movements can lead to problems like bursitis and tendinitis. Here are the things that can gradually lead to rotator cuff problems. They often occur together or overlap:. It takes tremendous force to tear a healthy rotator cuff tendon.

This may happen while you are playing sports or during an accident or a severe fall. In older, less active adults, even simple movements such as lifting a suitcase can cause a tear. Things that may increase the risk of rotator cuff disorders include:. As the rotator cuff and the shoulder weaken, the risk for a partial or complete tear increases.

Call or other emergency services immediately if shoulder or arm pain occurs with chest pain or other symptoms of a heart attack , such as shortness of breath and nausea. Call your doctor now if you have an injury to your shoulder and:. Watchful waiting is a wait-and-see approach.

If you get better on your own, you won't need treatment. If you get worse, you and your doctor will decide what to do next. A watchful waiting period may vary from a few days to weeks or maybe months. To diagnose a rotator cuff disorder, your doctor will ask about your injury or shoulder pain history and will do a physical exam to see how your shoulder is working.

If your symptoms and exam show that you may have a complete rotator cuff tear, you may have one or more of these tests to confirm the diagnosis:. Your age, job, and activity level are considered when your doctor is deciding about further testing. For example, if you are a competitive athlete or have a job that requires frequent overhead activity, you may need further testing sooner than a relatively inactive older adult.

A more complete diagnosis is important if you are likely to continue activities that may further damage your shoulder.

Treatment of rotator cuff disorders should begin soon after an injury or soon after symptoms develop, to give you the best chance of restoring flexibility and strength to your shoulder. Without treatment, inflammation and tears can build up, causing pain, weakness, and loss of function. Treatment depends on your symptoms, age, and activity level, and on whether your symptoms appear to be related to a rotator cuff injury.

Most rotator cuff disorders are treated without surgery. Your treatment may include:. If symptoms don't improve after a few months of nonsurgical treatment, you and your doctor may consider testing such as X-rays or an MRI to find out if you have a rotator cuff tear.

Or your doctor may give you a corticosteroid shot. Surgery often is used to repair a torn rotator cuff in a healthy young person, because good results are more likely if there is little or no evidence of degeneration or impingement.

People who have advanced rotator cuff disorders and tendons that are tough, stringy fibrous , and stiff usually respond less well to surgery. Surgery may successfully repair the tear, but it can't repair all the damage caused by age or degeneration. For more information, see Surgery. Recovery from a rotator cuff disorder varies with each person. Your physical therapy and home exercise program should continue until your shoulder is as strong and flexible as possible.

Some treatments for rotator cuff disorders can last up to a year. Most people can return to their previous activities after several weeks of rehabilitation. Experts have differing opinions about treating rotator cuff tears. The long-term changes that occur in and around the shoulder joint because of everyday wear and tear cannot be totally prevented. But you may be able to prevent some rotator cuff problems if you:.

Home treatment is often the first treatment for a rotator cuff problem. Treatment can help relieve the discomfort and keep the problem from getting worse. People respond to heat and ice differently. Use whichever one makes you feel better. In some cases, heat feels good for a while but may make pain and stiffness worse after 1 to 2 hours. For a sudden injury, don't use heat for the first 48 hours. At first, ice helps relieve pain and reduce swelling. Try applying ice to your shoulder for the first 48 hours after discomfort begins:.

After 2 to 3 days, start moving your shoulder with the aid of moist heat:. Eventually, your doctor may want you to do more to stretch and strengthen your shoulder. For exercises you can do at home with your doctor's approval , see:. Medicines don't heal rotator cuff disorders. They help with pain and inflammation. This allows you to start exercises to stretch and gradually strengthen the shoulder, which reduces the risk of stiffness or a frozen shoulder.

Be safe with medicines. Read and follow all instructions on the label. Surgery typically is used to repair a torn rotator cuff in a healthy young person, because good results are more likely if there is little or no evidence of other problems. If surgery isn't done right away, repair of a large tear may not be as successful. But it still usually relieves pain and restores enough strength for you to do routine, nonstrenuous activities.

After surgery, a program of physical rehabilitation rehab is very important. You may not do as well after surgery if you aren't willing or able to commit to completing a challenging physical rehab program.

Shoulder surgery for rotator cuff disorders usually involves one or more of the following:. These procedures may be done arthroscopically , by traditional open surgery, or by a combination of the two approaches. Sometimes a rotator cuff tear is so severe that it can't be fixed in the usual ways.

If this happens in a younger person, the doctor may suggest moving another tendon to substitute for the torn tendon. In an older person, the doctor may suggest a special shoulder replacement.