Rotator Cuff Tear Adelaide - Treatment and Surgery
Dr Arthur Turow Shoulder SurgeonRotator cuff tears are a common cause of shoulder pain and weakness. They often occur after an injury or can result from age-related wear, making everyday tasks difficult. Dr Arthur Turow is an Adelaide-trained orthopaedic surgeon who specialises in shoulder and upper limb conditions. He offers expert diagnosis, treatment guidance and advanced arthroscopic rotator cuff surgery, delivering best practice care to patients with rotator cuff tears. Dr Turow helps patients across South Australia recover strength, restore movement, and return to their daily activities.
The rotator cuff is a group of muscles in your shoulder helping with stability and movement
Rotator cuff tears can lead to shoulder pain, weakness and stiffness
Most rotator cuff tears can be treated without surgery
If your shoulder is not improving & you have persistent shoulder pain & weakness, you may need surgery
Surgery for rotator cuff tears is done arthroscopically (key-hole)
Recovery after rotator cuff surgery can take 4-6 months
What is the rotator cuff?
The rotator cuff consists of four muscles and their tendons that encircle the shoulder joint. The rotator cuff provides stability to your shoulder and helps your shoulder move. Rotator cuff tears happen when these tendons suffer damage either from an injury or, from wear and tear.
There are two types of rotator cuff tears:
1. Partial thickness tear: This type of tear affects a portion of the tendon usually starting small and potentially worsening if left untreated.
2. Full thickness tear: This tear involves a complete rupture of the entire tendon from its bony attachment. It can occur suddenly due to an injury or gradually over time due to changes in the tendon.
What are the most common causes for rotator cuff tears?
Several factors can contribute to a rotator cuff tear. The top three common causes include:
Acute injury: A sudden traumatic event like a fall, heavy lifting or direct impact to the shoulder can injure the rotator cuff. An acute injury typically leads to loss of motion and weakness.
Degenerative changes: As we age, natural wear and tear of the rotator cuff tendons occurs. In addition, capacity of the rotator cuff to repair itself is reduced. These processes lead to degeneration and weakening of the tendons, making them more susceptible to injury and tearing. In cases of degenerative tears, loss of motion and strength tends to occur gradually rather than suddenly.
Repetitive movement: Engaging in repetitive actions such as continuous work exposure, throwing, lifting heavy objects or taking part in specific sports can gradually result in tears within the rotator cuff due to strain on the shoulder joint.
What are the common symptoms?
A rotator cuff tear often causes shoulder pain and weakness. Pain and weakness usually are most noticeable with activity, for example when raising your arm above your head when getting dressed or reaching into cupboards. Pain can sometimes persist at night, especially when lying on the affected side. Sometimes you may also feel a catching or clicking sensation in the shoulder with movement. Together, these symptoms can make everyday activities difficult and limit quality of life.
Diagnosis and When to Seek Help
A rotator cuff tear is usually diagnosed with a physical examination and imaging such as an ultrasound or MRI. These tests help to confirm the size and location of the tear. You should see a shoulder specialist if pain has lasted more than 2-4 weeks and has not responded to simple treatments, such as rest and physiotherapy. Early diagnosis can make treatment easier and may improve long-term results.
Treatment Options In Adelaide
The treatment for a rotator cuff tear depends on various factors, such as the size, location, and severity of the tear. In addition, your symptoms, your functional goals, and overall health can guide treatment. If you have a full thickness cuff tear that has occurred because of an injury or are experiencing loss of function not responding to non-operative measures you may benefit from surgery. The broad treatment options are:
Non-surgical Treatment:
- Rest and activity modification: Avoid activities that aggravate your shoulder. Allow your shoulder to rest and heal. A sling may be beneficial to help you for the first few weeks.
- Physical therapy: Specific exercises and stretching of your shoulder may be helpful. Your physiotherapist can guide you through strengthening exercises of your rotator cuff, improve your shoulder mechanics, and work on stiffness to restore your range of motion.
- Pain management: It is best to stick to simple pain relief, such as Paracetamol (Panadol) or nonsteroidal anti-inflammatories (NSAIDs; Nurofen). Long-term use of strong pain killers should ideally be avoided, but can be used for a brief period to help you recover. Other options are injections of your shoulder with corticosteroids to reduce pain and inflammation.
- Other alternative modalities: Heat or cold therapy, shockwave therapy, laser therapy, or electrical stimulation can alleviate pain and promote healing. Everyone responds differently to these treatment options and you may need to trial different options to find out what works best for you.
Surgical Treatment:
- Arthroscopy: This is a minimally invasive procedure in which small incisions are made, and a specialised camera and surgical instruments are used to view and to repair your torn rotator cuff tendon.
- The rotator cuff is repaired back to bone using strong anchors that are inserted into your bone. The anchors have several sutures inside them which are used to tie down the rotator cuff tendons and to compress them against your bone. This allows the rotator cuff to heal and to restore your strength and range of motion.
Shoulder Arthroscopy
Why Choose Dr Arthur Turow for Rotator Cuff Surgery in Adelaide
Shoulder Specialist: Subspecialty training in shoulder and upper limb surgery
Advanced Techniques: Arthroscopic and open repair methods tailored to each patient
Local Expertise: Accessible care across Adelaide and South Australia, including Yorke Peninsula, Gawler and Mt Barker
Patient-Centred Care: Personalised treatment tailored for every patient
Recognised Training: Fellow of the Royal Australasian College of Surgeons (FRACS) with additional memberships of the Australian Orthopaedic Association (AOA) and Australian Medical Association (AMA)
What to expect after rotator cuff surgery?
Stage 1 – Protect Repair
- In the first six weeks the repair needs to be protected
- You can start on some early range of motion from two weeks
- You will need to wear a sling during this time
Stage 2 – Increase Range of Motion
- This stage covers weeks 6-12
- The sling is gradually weaned
- You start on active range of motion
- Low-resistance strengthening is introduced
Stage 3 – Strengthening
- The next three months you focus on strengthening
- Resistance training is increased
- You can return to swimming
Stage 4 – Return to full activities
- From six months onwards you can return to full activities
- You can return to sports and manual work
Frequently Asked Questions
Can a rotator cuff tear heal on its own?
While some healing is possible, most rotator cuff tears tend to get larger over time. The biology of rotator cuff tears is complex and healing depends on why your rotator cuff has torn. Although rotator cuff tears may progress over time, this may not necessarily mean that your shoulder will get weaker or lose function. If you are concerned about your shoulder or any imaging findings, it is best to have your shoulder assessed by a specialist.
How do I know if I have a rotator cuff tear?
Common signs include shoulder pain and weakness when lifting your arm leading to difficulty with overhead activities. An ultrasound or MRI can confirm the diagnosis.
Do all rotator cuff tears need surgery?
Not always. Small or partial tears can often be treated with non-operatively, such as physiotherapy. Surgery may be needed if your shoulder continues to have pain and weakness, the tear is large, or your shoulder does not function properly and you cannot retun back to your activities.
What is recovery like after rotator cuff surgery?
Most patients need to wear a sling for 4-6 weeks and begin physiotherapy soon after surgery. Full recovery and strength often take up to six months, though can vary, depending on the size of the tear and your activity level.
For Patients
If you are experiencing shoulder pain, limited mobility, or have other shoulder symptoms after a rotator cuff tear, book an appointment with Dr Arthur Turow at one of his clinic locations in Adelaide to discuss the right treatment for you.