Rotator Cuff Tears / Impingement
Tendinitis and Bursitis
Tendinitis occurs when shoulder tendons are pinched by other anatomic parts, causing inflammation and soreness.
Frequent overhead reaching (such as in manual labour or sporting activities) and rheumatoid arthritis cause bursitis. This condition results in the bursas - small sacs filled with fluid that allow the shoulder joint to function - becoming inflamed.
Tendinitis and bursitis often arise simultaneously.
Symptoms
- The shoulder's front or arm's side is swollen and painful
- Stiffness
- Inability to lower or raise the arm or reach behind the back without pain
- Arm movement causes clicking sounds
- Sleeping difficulties due to pain when lying on the shoulder
- Warmth in the affected area
- Skin redness
- Increased pain during movement and at night
Treatment options
Non-surgical treatments
- Ice and rest
- Anti-inflammatory medication
- Exercises and stretching aimed at regaining shoulder strength
- Conduction of infrared treatments or an ultrasound to promote blood flow to the shoulder
- If these treatments are ineffective, cortisone injections may be administered.
- Surgery may be recommended if the pain remains after 6 to 12 months.
Surgical treatments
Mini open surgery
Dr Brumby-Rendell’s preference is for keyhole repair, however, if the tendon tear is complex or large, it may need  a mini open incision (approximately 4 cm) to accurately repair the tendon. This technique is well-proven and has the same outcomes as keyhole rotator cuff repair.Â
Arthroscopic (keyhole) surgery
Arthroscopic techniques are a fantastic way to address pathology in the shoulder using multiple small keyhole-sized incisions. Dr Brumby-Rendell uses keyhole incisions for all shoulder arthroscopy procedures to address bone spurs, damaged tissues and soft tissue repairs. Dr Brumby-Rendell utilises minimally invasive methods to aid recovery and reduce post-operative pain.Â
Recovery from surgery
Generally, patients remain in the hospital for one day or less.
Depending on the surgery type, patients may return home on the same day as their operation. Post-surgery recovery consists of shoulder immobilisation via a sling and the application of cold packs to the affected area. These measures will reduce swelling and pain, and reduce the risk of complications. Dr Brumby-Rendell will monitor your healing and prescribe medication for pain if required.
The tendon often takes a lengthy period to heal. Your healing arm will have a restricted movement range throughout the first 6 to 12 weeks post-surgery. Dr Brumby-Rendell does not advise pushing or lifting heavy items during this time, as such could result in re-tearing internal structures before they have properly healed.Â
Physical therapy and exercises aimed at strengthening your muscles will commence after around 8 weeks. It is very important that you commence a supervised shoulder rehabilitation program for optimal recovery.Â
Recovery Timeline
Returning to work after rotator cuff surgery
Before your surgery, it is important that you discuss with your employer a return-to-work plan.
Depending on your specific surgery, your arm will be immobilised with a sling for 2 to 8 weeks.
After your check-up with Dr Brumby-Rendell (2 weeks after surgery), you will be able to perform non-strenuous, altered duties. However, you must wait a minimum of 3 months before partaking in activities that contribute to shoulder stress (i.e., heavy lifting).
Driving after rotator cuff surgery
Quality care provided by an orthopaedic surgeon.
After rotator cuff surgery, it is important that you refrain from driving until you can do so safely. If you drive too soon post-surgery, you could risk your recovery and the safety of yourself and other drivers.
Dr Oscar Brumby-Rendell's recommendations addressed below are a generalised guide of what may be expected after your surgery and should be used only as a reference. It is important that you discuss with Dr Brumby-Rendell your travel needs and recovery expectations before your surgery for individualised information.
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