Rotator Cuff Disease
Tendinitis and Bursitis
When tendons in the shoulder become inflamed and sore from being pinched by other shoulder parts, it is known as tendinitis.
Bursitis is caused by overuse of the shoulder during sports or manual labour which requires overhead reaching as well as rheumatoid arthritis. It causes the small fluid-filled sac that helps protect the shoulder joint, known as the bursa to become inflamed.
Often tendinitis and bursitis can occur at the same time.
- Pain and swelling at the front of the shoulder or side of the arm
- Pain when raising or lowering the arm
- Clicking sounds when moving the arm
- Difficulty sleeping on the injured shoulder
- Pain when reaching behind your back
- Shoulder pain
- The affected area feels warm
- Increased pain at night
- Pain increased by movement
- Reddening of the skin
- Rest and Ice
- Anti-inflammatory medication
- Ultrasound or infrared treatments to help improve blood flow in the affected area
- Gentle stretching and strength building exercises
- Cortisone injection if the shoulder does not improve
- Surgery after 6-12 months
Dr McLean makes a surgical incision, opens the shoulder, moves the deltoid out of the way, and repairs the tear. This method is used for larger or complex tears.
This method combines the previous two techniques. Damaged tissue or bone spurs are repaired or removed using arthroscopy (key holes) and then mini-open surgery is used to repair the rotator cuff. Wherever possible, Dr McLean uses minimally-invasive techniques for faster recovery and minimal pain.
What to expect after rotator cuff surgery
Patients will usually be in the hospital for no longer than one day. Some patients are discharged on the same day, depending on the type of surgery they have had. Immediately after surgery, you will be advised to keep your shoulder pain a sling to protect the repaired tendon. The frequent application of cold packs to the area will help reduce your pain and swelling. Dr McLean will prescribe you pain medication according to your needs.
Waiting for the tendon to heal can take a significant amount of time. During the first 6-12 weeks of your recovery, you will only be able to perform a modified range of motion with your healing arm. Lifting or pushing heavy objects is not recommended, as the strain on your joint may cause your internal sutures to tear and/or the repair to fail before the tendon has healed.
After approximately 8 weeks, you will begin to perform strengthening exercises and physical therapy. Completing a shoulder rehabilitation program supervised by a trained physiotherapist is crucial for your full recovery. Read more about why physiotherapy is so important, in this article recently published by Dr Mclean.
Rotator Cuff Surgery Recovery Timeline
Returning to work after Rotator Cuff Surgery
You need to discuss a return to work plan with your employer prior to your surgery. Your arm will be in a sling for approximately 2 weeks after surgery (this is highly variable and may be up to 8 weeks in some cases).
Light, modified duties can be performed after your two-week follow-up with Dr McLean. However, heavy lifting or activities that place stress on the shoulder should be avoided for at least 3 months.
Driving After Rotator Cuff Surgery
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It is normal to want to get back into your usual routine as soon as possible after surgery. However, it is important to wait until you are safely able to drive before returning to driving after rotator cuff surgery. Your own post surgery wellbeing, as well as the safety of others on the road, could be at risk if you choose to drive too soon.
Adelaide Orthopaedic Surgeon Dr James McLean’s recommendations on this page are a rough guide to driving after rotator cuff surgery. Use this guide for reference only. To avoid disappointment, please discuss your individual situation and expected recovery milestones with Dr McLean prior to your scheduled surgery.
How soon can I drive after rotator cuff surgery?
After your surgery, you will be encouraged to protect your surgical repair. Your arm will be immobilised in a sling for a minimum of 2 weeks (up to 12 weeks).
It is recommended that you wait for at least 6-8 weeks before getting back behind the wheel.
Operating a car with one arm is dangerous and should be avoided. Driving too soon also increases your risk of damaging your shoulder in an emergency stop situation. In addition, pain medication may impair your ability to drive safely.
You should not attempt to drive until you are out of your sling, your pain has subsided and you can confidently perform manoeuvres needed for safe driving.
Ortho SA Dr James McLean can give you a professional assessment of your ability to drive safely during your consultation.
Car insurance considerations
Your car insurance may not cover you for a certain period of time after your surgery, especially if you are taking pain medication. Before you get back behind the wheel, discuss your policy restrictions with your insurer.
Returning to safe driving
Your shoulder must be healed enough for you to safely control your vehicle under all conditions before you get back behind the wheel.
Consider the following before deciding to drive again:
- The type of car you drive (manual, power steering)
- Driving conditions (bad weather, poor light)
- Your journey length (longer trips may fatigue you)
- The level of pain you’re in
- Functionality in your shoulder and arm
- Your mental capacity to drive (lucid, medicated or distracted by pain)
Test your driving ability in a safe environment (such as an empty car park) before going back on the road. If you can safely and repeatedly perform the maneuvers driving requires – including emergency stops – you may consider returning to driving.
Do not push yourself – begin with short trips accompanied by another driver and gradually build up to your old routine.
Driving and pain relief
Dr McLean may prescribe anti-inflammatory or pain medication for the first few weeks post-surgery. Pain medication can affect your ability to drive safely by interfering with your judgement, reaction time and ability to concentrate. DO NOT drive while under the influence of pain medication.
How does your shoulder pain affect you?
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Shoulder pain can be caused by many different conditions. Here you will learn whether your pain is normal or if you should seek medical advice.