Rotator cuffs – A shoulder dilemma

Rotator cuffs – A shoulder dilemma

The Rotator Cuff is a group of 4 muscles and tendons that surround your shoulder. They are responsible for the movement and stability of the shoulder. They are a source of pain but also confusion when it comes to treating patients, especially those over the age of 40.

So many patients walk in the door already with MRI in hand. Doc I have a tear in my rotator cuff! They say. Let me look at the films, I say. More often than not is it says “partial tear” “fraying” “tendinitis” and occasionally the dreaded “full-thickness tear”. Occasionally the radiologist will throw in a “can’t rule out” just to add some fun confusion to the mix. My favorite is “non-displaced” full-thickness tear. Not sure what that means.

I don’t mean to make fun of my radiology colleagues. However, they don’t see the patients putting in perspective the findings. I always look at my patients’ MRI films myself with the patient. You should always seek out a surgeon who does the same.

Rotator cuff injury treatment could be very cookbook if we wanted. But that’s not the way I treat it. I tell all my patients each patient with a rotator cuff injury is unique. I have patients with partial tears in a ton of pain and other patients with an enormous tear and no pain. And everything in between.

The rotator cuff tendons start to tear as part of the aging process in general after the age of 40. It is not always the reason your shoulder hurts. Let me repeat. It is. NOT always the reason your shoulder hurts. A good history, physical examination, and individualized treatment plan are essential to you getting better. Sometimes no treatment is the answer. Sometimes rest. Sometimes injections. Sometimes surgery. I do it all.

The key to getting better with a shoulder injury, in general, is to find a doctor who is willing to sit down and listen to your story. Review carefully Xrays and MRI and individualize the treatment to you.

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