Rotator Cuff

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I Injured my shoulder! Should I rest it?

0352bI injured my shoulder!  Should I stop working out? Should I wear a sling? Should I see an orthopaedic doctor?

Depending on the circumstances surrounding your injury or pain, these questions may be swirling about in your head, and the answer to these questions could vary.

Of course, very mild aches and pains can be a normal part of life.

Illness, exercise, sports, aging…all of these can lead to soreness, mild temporary aches, and fatigue. It would be unusual to pass an entire lifetime without any trace of discomfort in our bones and joints. These types of pains can and should certainly be tolerated and should not cause alarm. When we do experience them, it is best to stay active and not allow these symptoms to affect our active lifestyle.

However, shoulder pain that is more severe, longer-lasting, or accompanied by significant weakness or loss of motion should not be “brushed off.”

An orthopedic shoulder specialist like Johnny T. Nelson, MD is specially trained in diagnosis and treatment of any and all causes of shoulder pain.  Based on questions that he will ask you about the type of pain you have, location of the pain, how long the pain has been present, as well as findings on physical examination, x-rays, and possibly ultrasound of your shoulder, he will be able to give you direction on whether or not further treatment is necessary or if it is okay to continue with life as usual.

For example, if your pain began after a more serious accident, for example a car accident or a fall, it is very important to rule out serious problem such as broken bones or torn rotator cuff tendons.  This is usually done with a combination of x-rays and physical examination. Dr. Nelson also uses in-office ultrasound to diagnose these conditions as well without having to resort to more costly and time-consuming MRIs.

There are other conditions, such as bursitis, rotator cuff tendinitis and inflammation, and arthritis that are okay to live with, and continuing to workout is usually okay and safe.  Of course, some modifications of your workout regimen may be necessary to avoid inflaming or aggravating the shoulder further.

It is almost never necessary or advisable to wear an arm sling or shoulder immobilizer unless a physician recommends it.

Unnecessary sling use can lead to more stiffness and pain, and does not contribute much to healing. Slings are usually only used for short periods of time after either serious shoulder injuries (broken bones or dislocations) or after shoulder surgery.

Sometimes if the patient has very severe pain, it may be a good idea to stop working out for a short whi6993ble to focus on more basic exercises to rebuild shoulder health, such as strengthening the rotator cuff muscles, stretching out the shoulder blades, and working on posture and core strengthening. This also allows for time for a proper workup to rule out more serious causes of pain (for example, rotator cuff tears).

Also, as we age, some types of exercising, such as very heavy weights and plyometrics, may not be suitable for our level of conditioning and physical activity, so it may be necessary to discontinue some exercises altogether.  However, every exercise that is discontinued should be replaced by another because, as Dr. Nelson always says, if you don’t move it, you lose it!

Once a diagnosis is made, Dr. Nelson can then recommend treatment.  Very rarely, this includes surgical treatment, but more often it may include watchful waiting, oral anti-inflammatories, physical therapy, injections, a home exercise program, chiropractic care, or possibly even referral to a different physician.

Do you have shoulder pain? Are you unsure of where to go next or who to listen to? Call 919-872-5296 to make a visit with Raleigh’s Shoulder Doctor, Johnny T. Nelson MD.

do i have to have surgery for a rotator cuff tear 62767fac148b3

Do I Have to Have Surgery for a Rotator Cuff Tear?

do i have to have surgery for a rotator cuff tear 62767fac148b3Do I have to have surgery for my rotator cuff tear?

You may have recently been given a diagnosis of rotator cuff tear. Often, this can be given by a surgeon based on physical exam, a physical therapist based on your symptoms, or even based on imaging studies such as x-rays or MRI.

This diagnosis may lead to many questions for you.

Some patients think that just because rotator cuff tear is present, there is an immediate need for surgery. This is not actually true, as rotator cuff tears come in many different “flavors.” That is why it is very important to allow a shoulder expert like Dr. Johnny Nelson to examine your shoulder and discuss your unique situation with you.

It is important and helpful to look at the rotator cuff like a rope made out of a bunch of fibers. Some ropes are extremely new and extremely healthy, completely intact without any tearing or fraying. Other ropes may have some tearing and fraying of the fibers but overall remained intact. Then again other ropes may be completely torn, cut, or snapped and unable to be used.

The rotator cuff tendon is the same way.

Some patients have completely intact rotator cuff, with no tearing or fraying or even inflammation. Some patients have mild tearing of a few of the muscle and tendon fibers, while some patients have complete tears where the muscle is not connected to the bone.

We do have some evidence that smaller rotator cuff tears are less likely to become large tears, possibly scarring in place and healing. We also have evidence that large rotator cuff tears are more likely to get larger over time, and are less likely to be repairable the longer they are left without repair.

As a general rule, younger more active patients with more severe tears are more likely to be offered surgery and are more likely to respond well to that surgery. Patients with small tears are less likely to be offered surgery because there is evidence that these patients will often heal without surgery. However, even for small tears surgery is sometimes offered when treatments such as physical therapy, anti-inflammatory medications, and injections do not bring lasting relief of their pain and weakness.

If you have been told that you have a rotator cuff tear, or if you have been told that you need surgery on your shoulder, do not hesitate to make a visit to see Dr. Johnny Nelson to discuss your shoulder.

Sometimes knowing is half the battle!

 

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