Shoulder Pain - Partial Rotator Cuff Tears

Hello, I'm Dr. they cry out and this is a video and today I'm going to talk to you a little bit about

partial

rotator

cuff

tears

on

rotator

cuff

day. Today I will talk to you about

partial

rotator cuff

tears

. Know that there are differences, there are different ones. types, there are full thickness rotator cuff tears and then there are partial rotator cuff tears and today we're just going to touch on partial rotator cuff tears, what that means, what it looks like, how we operate on them and what the recovery is like. I hope you like this video.

Please let us know what you think. We've discussed anatomy in the previous video, so I'll just do a quick review just for those of you who may not have seen the other videos, so we'll talk about anatomy in the next one.

shoulder

and just the highlights here so what we're looking at is a little diagram that I put together and I think it's very helpful to have a diagram that makes it easier to understand so the rotator cuff muscles are a group of four muscles that surround the

shoulder

, the ball of the humerus, which is the ball and socket of the joint and these are shown in red and the rotator cuff muscles, like any muscle, becomes a tendon which is a kind of gray, thick and strong, and that's what attaches to the bone, so here we're showing two of the rotator cuff muscle tendon units as they attach to the ball at the shoulder.

Now there is also something called a bursa. The bursa is a small sac of fluid, sort of like a balloon, so to speak. It helps things slide a little easier and we have them all over our body, in all of our joints, so what is a partial rotator cuff tear? So what it really is is a fray, if you will, at the end of a rope where it frays. And we see the same thing with the tendon, it can fray and partially tear and it usually happens on the bottom surface of the tendon, so there are two sides, the bottom surface and the top, and these partial tears are usually on the bottom surface.

Now this is different than a full thickness tear in this diagram which you can see, it would represent a full thickness tear where the tendon has completely detached from the bone and retracted, but that is something for another video and again , so again we'll show it again here. the partial rotator cuff is frayed like at the end of the rope and those fragments can catch on the joint and cause

pain

in this clip we are looking inside the joint here you see the biceps tendon and then there is the blade of the rotator cuff and rotating on the ball of the humerus, the ball and the shoulder and this is an interarticulate view here I have written it, you can see where the rotator cuff tendon is and where the biceps tendon is and where the humeral head is okay, so here we are seeing to a patient with a partial rotator cuff tear and you can see those torn fragments that get stuck inside their joint and that's a shaver that we put in that has suction and we can debride, which means remove and remove.

We get rid of those fragments that get stuck inside the shoulder and cause

pain

and we move it, we remove all those torn fragments back to a smooth, stable edge that doesn't leave any edge that can catch and cause pain to the patient. Hello, it's Dr. Claman again after the operation, what can we expect? Well, first, let's start from the beginning. When you have surgery, these types of procedures for a partial rotator cuff are generally what we call outpatient, meaning you're going to come in and go home the same. day and that's good because no one really wants to have to stay in the hospital if they don't have to.

So how do we achieve it? How can we take him home the same day? Typically, patients will receive a type of anesthesia we call regional anesthesia, which is basically an injection we call an interscalene block that numbs your shoulder and arm and usually lasts several hours, which is great because you go home. and you don't feel pain, eventually the blockage wears out. it goes away after several hours and then there will be pain we generally advise our patients to start taking their pain medications before the pain starts, it's easier to anticipate the pain and we found that that seems to help the other thing we've discovered.

That sleep has been a complaint that patients often have that they have more pain at night when they sleep. You know, trying to find the most comfortable position is always helpful. Sleeping on that shoulder we don't recommend and that would certainly aggravate the pain and any type of sleep we've heard about has been problematic. One thing that many of our patients have found that has been helpful is getting what's called a wedge or a bunch of pillows that will help you prop yourself up so you can see the type of position better and that seems to help decrease the pain after surgery. , we often wear a sling and the sling helps with comfort, which is different here when we have a partial rotator cuff that we're clearing and breathing like we saw in the previous video. there is no healing of a tendon and we have to wait like in a full thickness tear, so it is just about comfort and usually patients get rid of the sling after a day or so, just as the pain relief increases a little from each other.

What we have found very helpful in reducing the pain is one of these ice compression machines and devices that provides a little bit of compression and the ice really helped eliminate a lot of that pain and we found it to be very effective. In terms of recovery, we get that question, it's understandable that you want to know how soon you're going to get back to your life and your sports and things like that, obviously it's different from patient to patient and genetics plays into that and what you do and in that. type of thing, but we would say that generally around two or three months would be a normal recovery for this type of procedure, of course, everyone is different and we recommend that you talk to the orthopedic surgeon about your specific situation in case it exists . any specific questions thanks for watching this video have a great day