Dr. Caillouette Orthopedics

The muscles and tendons surrounding top of the upper arm bone (humerus) make up the rotator cuff. These muscles and tendons hold the bone in place in the shoulder joint.

	Pain with overhead activities
	Muscle weakness when lifting the arm
	Pain at night on the affected side
	Catching, grating, or cracking sounds when the arm is moved
	Limited shoulder motion
	Usually occurs in the dominant arm (right arm for right-handed, left arm for left-handed)

Dr. Caillouette will closely examine the top of you back and shoulder, looking for signs that any muscles have begun to atrophy. (shrink) You will be asked to move you arm and shoulder in many directions and to hold a series of positions. X-rays may aid in the diagnosis, although additional tests may be required. Additional tests may include an anthrogram, MRI, or ultrasound.

Non-Operative Treatments:

Partial rotator cuff tears may respond well to non-operative treatments. There are a number of non-operative treatments for rotator cuff tears, including the following:

	Rest. This may be particularly effective if the injury is due to overuse.
	Nonsteroidal anti-inflammatory medications for pain management
	A physical therapy program that includes strengthening and stretching exercises.
	Corticosteroid injections to reduce pain. These cannot be repeated frequently due to risk of tendon weakening.
	Ultrasound can enhance the delivery of topically applied drugs and has thermal effects that may aid the healing process.

Surgical Treatment Options:

	Arthroscopy to remove bone spurs, inflammatory portions of muscle, and to repair lesser tears.
	Mini-open repair combining arthroscopy and a small incision to treat full-thickness tears.
	Open surgery, for more severe cases, to repair the injured tendon. Sometimes a tissue transfer or a tendon graft is used. Joint replacement may also be an option.

Surgical Rehabilitation:

After surgery, your shoulder may not be fully functioning for 3 months or longer. Dr. Caillouette will recommend a program of exercises to strengthen your shoulder and restore motion. Although every patient is unique, surgery can relieve pain for most people and rehabilitation can restore a functional range of motion.