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Not All Rotator Cuff Injuries Are Equal Says CareMount Medical Surgeon

Dr. Evan H. Karas.
Dr. Evan H. Karas. Photo Credit: CareMount Medical

MOUNT KISCO, N.Y. -- Whether it’s combing our hair, getting dressed, or just reaching for a snack in the fridge, many everyday activities require us to lift our arms. Unfortunately, those with a rotator cuff tear in their shoulder often can’t make simple movements without pain and weakness. However, thanks to advances in surgical and non-surgical procedures, patients with shoulder injuries are returning to pain-free lives sooner than ever before.

The rotator cuff is a network of four muscles joined together as tendons which cover the head of the upper arm bone. The cuff keeps the arm in the shoulder socket and helps lift and rotate the arm. When the rotator cuff becomes torn, it can present a big problem and demands effective treatment.

"Rotator cuff tears aren’t rare," said Dr. Evan H. Karas, an orthopedic surgeon with CareMount Medical in Mount Kisco. According to the American Academy of Orthopaedic Surgeons, approximately two million Americans each year visit doctors because of problems with their rotator cuff. Tears are primarily caused by one of two issues: degeneration -- which occurs slowly over time and can’t necessarily be prevented -- and injury, which can show up as a complete and sudden tear.

Rotator cuff tear treatment typically starts with conservative, non-surgical measures. "In roughly 50 percent of patient cases, this approach relieves pain and improves function," said Dr. Karas. Conservative treatment options include rest, avoiding certain shoulder movements, anti-inflammatory drugs, physical therapy and steroid injections.

However, if shoulder pain doesn’t improve over several months with non-surgical treatment, the next step toward relief may be surgery. And just as there are different types of rotator cuff tears, there are different types of surgery used to repair them. One such procedure is arthroscopic surgery. "By inserting a small camera known as an arthroscope into the shoulder joint, surgeons use tiny surgical instruments to repair or reconstruct the rotator cuff," said Dr. Karas. "Other treatments include Superior Capsular Reconstruction for tears that have progressed to become irreparable and shoulder joint replacement, also know as arthroplasty, for massive rotator cuff injuries."