You may not give your shoulders much thought, that is, until you reach for that plate on the top shelf or hit an overhand tennis serve and it hurts. Rotator cuff injuries can be quiet, while those requiring intervention are more vocal affecting range of motion, daily living and even sleeping.

However, having a rotator cuff injury does not automatically mean surgery and a lengthy recovery, as treatment plans often begin with non-operative options!

What is the rotator cuff?

The rotator cuff is a group of four muscles acting in unison to stabilize the shoulder. These muscles are crucial in the balance and function of the shoulder, especially its ability to move.

“When one or more of these muscles is injured, it disrupts that balance and it leads to dysfunctional movement of the shoulder. The shoulder doesn’t like to move in ways it’s not supposed to, and once injured, other muscles will compensate,” said Dr. Zapf. “This creates an abnormal movement pattern which can predispose you to pain, injury and further dysfunction.”

Who gets rotator cuff injuries?

For people under 40, a rotator cuff injury is typically caused by a traumatic injury. Most rotator cuff injuries occur in people over 40 with the risk increasing with age. A startling statistic shows up to 80 percent of people in their 80s will experience a rotator cuff injury, yet most remain asymptomatic and not in need of surgery.

Age is not an excluding factor for receiving a treatment that can recapture independence or get a person back to the activities they love, rather it is a person’s youthfulness and level of activity that are deciding factors.

How can you prevent or protect a rotator cuff injury?

Strengthen – Optimizing shoulder movement to prevent a rotator cuff injury can be accomplished by strengthening the rotator cuff muscles and the stabilizing shoulder muscles. Coordinated muscle activity is paramount to shoulder movement and function. When injured, physical therapy and home-exercise programs can re-establish this balanced function and potentially ward off future injury.

Avoidance – Avoiding activities that can lead to symptoms, such as strenuous overhead activities, may reduce the likelihood of a rotator cuff injury or protect a minor injury from becoming worse.

What are the symptoms of a rotator cuff injury?

• Shoulder pain
• Arm pain
• Worsening pain or returning pain after a period of relief
• Pain with specific movements such as overhead motions
• Pain at night
• Weakness
• Sudden onset that leads to weakness

How to prepare for treatment?

Strengthening the muscles is crucial to obtain optimal recovery, for non-operative and surgery-bound patients alike. Even before surgery, patients are recommended to strengthen key shoulder, back and arm muscles for the best possible outcome.

Non-operative treatment includes

• Establishing treatment goals
• Pain relief
• Maximizing range of motion
• Physical therapy and individualized home exercise programs to optimize strength and muscle coordination

The only group of people for whom surgery might be considered earlier than later are those who have experienced a traumatic injury. For most patients, the journey includes exhausting all non-operative measures before surgery is recommended.

Recovery after rotator cuff surgery

Patients undergo extensive physical therapy both before and after surgery. Beyond influencing surgical outcomes, the resulting gains in strength and muscular balance can produce significant improvements in general health.

“But when can I get back to golf?” is a common question posed. Patients can often begin chipping and putting at about four to six months post-surgery, but each person’s progress is individual and a full return to the sport may take longer.

“A reliable return to sports can be expected with rotator cuff surgery,” Dr. Zapf said. “Our goal is not just to get you over the shoulder injury, but to improve your overall level of health so you can go back to doing the things you love whether that’s pickleball, tennis, golf, swimming, cycling or picking up the grand kids.”