From an interview with
Dr. Thomas DiStefano
McLeod Orthopaedics Cheraw
People, who do a lot of reaching over their head, and many older people end up with a bad rotator cuff in their shoulder. McLeod Orthopedic Specialist Dr. Thomas DiStefano explains ways to treat this problem.
Here’s a summary of Dr. DiStefano’s comments:
Rotator cuff inflammation and tears are a very common problem. The shoulder is a very painful joint when it’s inflamed. The rotator cuff is four muscles that attach about the top of the shoulder joint. It’s the lack of sleep that eventually brings people to my office.
Overuse can cause inflammation in the shoulder. People most at risk work in jobs that require a lot of activity with their shoulders (particularly overhead activity), jobs that require working on assembly lines or repetitive use athletes. But as we get older, shoulder inflammation becomes more common.
The whole treatment philosophy focuses on the rotator cuff as the most important structure in your shoulder. So, all of our treatment is geared toward the preservation of that tendon.
That’s why it’s important to see your doctor if you have pain in your shoulder that’s not going away, having difficulty sleeping, problems doing your job or issues with your activities, such as gardening, fishing or activities of daily living. We treat it conservatively by putting people on anti-inflammatory medicine, considering giving them a cortisone injection, and then at least starting them off with a one-time session with a therapist to learn the rotator cuff range of motion and strength in exercises.
The surgical treatment for rotator cuff tears has dramatically improved in my 20-year career. Now we use a technique with two rows of absorbable anchors and suture material almost a quarter inch. So now when we repair them, if they fail, the liklihood is that it’s due to the poor tissue quality the fixation into the bone, but not due to the actual fixation device. It’s stronger than your bone or your tendon. And that’s really changed the game, because we’re getting a lot more success for our patients.