skiing shoulder injuries

Skiing and the Shoulder: ACJ and Clavicle Injuries

Shoulder injuries are common in athletes, but rather than the repetitive motion injuries that plague sports such as cricket or baseball, skiers and snowboarders are at increased risk of falls. This can lead to a number of different skiing shoulder injuries, with the most common being ACJ and clavicle injuries.

Here, we’ll address these common injuries, the treatment required and how you can potentially prevent them.

What are ACJ and clavicle injuries?

ACJ (Acromioclavicular Joint injuries) and clavicle injuries relate to problems with the collarbone. The ACJ is the collarbone joint, while the clavicle is the collarbone itself. These types of injuries can occur alone or happen alongside rotator cuff injuries.

If you do suffer these types of injuries, you’ll experience both pain and swelling in the collarbone area. Initially, the pain may stretch throughout the entire shoulder and collarbone. However, after the injury settles down, the pain will mostly be felt in either the ACJ or Clavicle area.

The most common injury affecting the collarbone is a fractured clavicle. It can easily occur if you fall while skiing and land on your outstretched arm. This can be a really painful injury, with the pain worsening when the arm is lifted.

How are they treated?

London Shoulder Specialist and consultant orthopaedic surgeon Susan Alexander recently presented on these winter sport shoulder injuries at the recent Fortius International Sports Injury Conference.

She warns against succumbing to pressure to undergo surgery immediately if you suffer a clavicle fracture. “Not all clavicle fractures need fixing, so don’t feel under pressure to have surgery immediately at the ski resort. Some clinics are very keen to fix things immediately, but you should be able to safely return home and seek a second opinion.

“However, if you have a clavicle injury where the skin is broken, or which poses a threat to nerves and arteries or to other injuries, urgent attention will be required.”

If you suffer an ACJ injury, these can also usually wait until you arrive back home to be treated. Like clavicle injuries, these don’t always require treatment. It’s best to consult a shoulder surgeon, rather than just a fracture clinic to have the injury fully assessed. They will then be able to advise you of the best course of treatment moving forward.

Can you prevent these skiing shoulder injuries?

As the majority of these ski-related injuries are caused by falls, it can be very tricky to prevent them. Strengthening your core and making sure you only tackle trails you can comfortably handle, will however reduce the chances of some falls.

If you are just starting out with skiing, you can also make sure you take plenty of lessons before hitting the slopes properly. Ensuring you wear all of the relevant safety gear will also help.

Another common skiing injury is to the thumb, accounting for about 5% of all ski injuries and often known as Skier’s Thumb. As Susan explains, “a fall can cause the thumb to be forced backwards in the hand straps of the ski poles on impact, tearing the ligaments in the thumb”.

Her advice on how to avoid this injury: “The best prevention is to use your ski pole strap correctly. Put your hand through the bottom of the strap and hold your ski pole handle over the strap. This means you can quickly drop the pole and protect your thumb, while the pole remains securely strapped around your wrist.”

Overall, upper limb injuries are common in skiers and snowboarders. It isn’t always possible to prevent them, but treatment is available if you do suffer a serious injury. Mild to moderate injuries can often be resolved without the need for surgery. Before seeking treatment, it is a good idea to undergo a consultation with a specialist shoulder surgeon. They will be able to identify the problem and its severity.

For diagnosis and treatment of skiing shoulder injuries, call 0203 195 2442 to arrange a consultation at the London Shoulder Specialists.

surfing shoulder injuries

Surfing Injuries Found to Mostly Involve Knee or Shoulder

A new study has revealed that surfing injuries largely involve the knee or shoulder. Researchers from the Hospital for Special Surgery in New York, discovered shoulder injuries were the most prevalent, followed by knee injuries.

Interestingly, the study also revealed most knee and shoulder injuries suffered by surfers, don’t require surgery. Here, we’ll look at what the study revealed and how these injuries could potentially be avoided.

Understanding the study

The researchers from the New York-based hospital, carried out the latest study due to a lack of reported surfing-related injuries. They wanted to determine the kinds of injuries surfers experienced, particularly orthopaedic injuries.

A retrospective review was carried out, using medical records from patients who presented with surfing-related injuries from January 2009 to August 2018. They identified shoulder injuries were the most common, relating to 46% of surfing injuries. This was followed by knee injuries at 28%, foot and ankle related injuries at 9% and spine injuries at 6%.

The limited studies carried out prior to this one commonly pointed to the lower extremities and the head being the most commonly injured in surfing. However, this latest study reveals the opposite, highlighting the dangers to the upper body. Out of the shoulder injuries presented, most had suffered an anterior shoulder dislocation. In terms of knee injuries, torn medial collateral ligaments were most common.

Interestingly, the study also showed that out of all of the surfing injuries experienced, only 17% of patients required surgery to fix the issue. The conclusion of the study was that although surfers are at risk of injury, out of all of the different sports, it is still one of the safest.

Can these surfing shoulder injuries be prevented?

While surfing is considered one of the safest sports, it is still worth being aware of preventative measures you can take to reduce the risk of injury.

Making sure you’ve had adequate lessons before getting in the water is essential. This will teach you how to correctly manoeuvre the board through waves and how to keep your balance. Another thing that will improve your balance, is working on strengthening your core.

You should also pay attention to weather conditions. Being aware of riptides and rough waves will prevent you from taking unnecessary risks when surfing. However, as water conditions can change quickly, it isn’t always possible to prevent falls or injuries when surfing.

What treatment is required?

The treatment required for shoulder related injuries that occur during surfing will be dependent upon the type of injury sustained. If anterior shoulder dislocation has occurred, it could simply be popped back into place depending upon the severity of the dislocation.

Occasionally, surgery may be required but only for the most severe injuries. It is really important to seek a diagnosis from a trained shoulder surgeon. They will be able to assess the shoulder and pinpoint the exact problem, alongside the best course of treatment to resolve it. Most treatments will likely be non-invasive, particularly if the injury is mild.

For diagnosis and treatment of surfing shoulder injuries, call 0203 195 2442 to arrange a consultation at the London Shoulder Specialists.

shoulder pops while exercising

5 Reasons Why Your Shoulder Might Pop or Grind During Exercise

Do you find your shoulder pops or grinds during an exercise? As well as feeling strangely uncomfortable, this popping and grinding can also be preventing you from partaking in your favourite workout.

So, why does this happen? Here, you’ll discover 5 reasons popping and grinding of the shoulder can occur when you work out.

1. Loose shoulder ligaments

Although not as common as tight ligaments, some patients do experience discomfort or pain due to loose ligaments allowing abnormal movements of the shoulder. This is also often referred to as ‘double jointed’. It is known medically as ligamentous laxity. Physiotherapy is the starting point for treatment if symptoms are arising. Surgery is a last resort.

2. Shoulder impingement

Impingement is a common shoulder problem, caused when the subacromial bursa or the rotator cuff is pinched on movement. Anyone can develop this problem but it may be seen more often in overhead athletes. It can also lead to clicking of the shoulder. There are a number of treatments available for impingement, including exercises, steroid injections and finally surgery.

3. Gas build-up

Did you know over time, gas build up can occur within your joints? Known as cavitation, you won’t usually feel any pain, but it can lead to popping or grinding of the shoulder when you exercise.

This is because gases are released from the synovial fluid which is responsible for lubricating the joint. These gases contain a mixture of oxygen, carbon dioxide and nitrogen. As long as there is no pain alongside the popping sound, gas build-up doesn’t require any treatment.

4. Rotator cuff or labral tears

If the noise sounds more like grinding than popping, it could be down to a rotator cuff or labral tear. Both of these conditions can cause unusual noises when you exercise. Rotator cuff tears involve the muscles and tendons that are responsible for keeping the humerus within the socket. Labral tears affect the rubbery disc situated around the socket.

You’ll typically experience some level of pain if a tear is the cause. In order to treat these conditions, you’ll need to see a shoulder specialist and surgery may be required.

5. Shoulder arthritis

In some cases, the popping you hear could be down to osteoarthritis of the shoulder. The joints degenerate over time, reducing the space between the bones. This, in turn, causes the bones to start to rub together, resulting in a cracking or grinding sound when you exercise.

A shoulder specialist will be able to determine whether shoulder arthritis is the cause of the popping and you may need to avoid certain activities or make lifestyle changes.

These are just some of the main causes of why your shoulder pops or clicks when you exercise. As each cause requires a different type of treatment, it’s worth seeking a diagnosis from a professional. While some types of popping and grinding are harmless, others should be treated as soon as possible.

smoking and shoulder surgery

Smoking and shoulder surgery

Shoulder surgery, like any surgery, can present a number of risks. These risks can be increased due to numerous factors, with smoking being one of the main contributing factors.

A number of studies have been carried out to determine the risks smoking presents to shoulder surgery patients. The latest retrospective study into smoking and shoulder surgery has revealed its complication risks differ between procedures.

Here, we’ll look at what this latest study found and how smoking impacts the risks of different types of shoulder surgeries.

Understanding the latest study

The study took data from the National Surgery Quality Improvement Program database, compiled by the American College of Surgeons. In total, there were 134,822 cases included in the study.

The patients involved had undergone eight different shoulder and knee surgeries and were analysed using multivariate and univariate analyses. The shoulder procedures included in the study were arthroscopy with debridement, arthroscopy with subacromial decompression, arthroscopy with distal clavicle excision and subacromial arthroscopy with rotator cuff repair.

The study highlighted several complications in a 30-day period including pulmonary, wound, cardiac and clotting. Out of the procedures analysed, smoking was found to be an independent risk factor for two specific procedures. These were shoulder arthroscopy with debridement and arthroscopy with subacromial decompression.

Smoking and its effects on rotator cuff surgery

This latest study isn’t the only one to identify smoking as a risk factor for rotator cuff surgery.

A previous study carried out on 235 patients showed that the results of the procedure were better in non-smokers. They experienced a much higher degree of function, alongside less pain than the smoking group. Just 35% of smokers received good or excellent results, a lot less than the 84% experienced by non-smokers.

An earlier study which was carried out back in 2006, discovered that smoking could affect bone to tendon healing. Researchers from the Washington University School of Medicine found that nicotine exposure can delay healing between bone and tendons, potentially causing rotator cuff repair to fail.

In some cases, rotator cuff repairs were shown to fail within just days or weeks of the procedure. It is for this reason many surgeons refuse to operate on patients who smoke.

Other risks of smoking and shoulder surgery

It is known that smoking presents a lot of risks in and after surgery. Patients have an increased risk of suffering heart or lung complications. The risk of infection is also higher, as is impaired wound healing.

Smokers often also need to have higher levels of anaesthesia, which also presents its own risks. In rare cases, mortality can also occur, with smokers shown to be 38% more likely to die after the surgery. The risk of this is still small, but it’s higher than it would be if patients didn’t smoke.

This latest study interestingly reveals the impact smoking can have on specific shoulder surgeries. For this reason, it is advised patients to quit prior to undergoing surgery. The benefits of quitting smoking reach far beyond lowering the risk factors of procedures. You’ll also experience the benefits pretty quickly after stopping.

For more advice on how best to prepare for shoulder surgery, call 0203 195 2442 to arrange a consultation with the London Shoulder Specialists.

shoulder sport injury conference

London Shoulder Specialists present at the Fortius International Sport Injury Conference

Earlier this month, the third Fortius International Sports Injury Conference took place in London. The two-day event brings together orthopaedic surgeons, sports physicians, physiotherapists and other healthcare professionals with an interest in sports injury and invites leading international experts to present and debate on multi-disciplinary panels. 

On day one, London Shoulder Specialist Susan Alexander chaired a panel entitled ‘Bowled Over – The Cricketing Shoulder’. She was joined by Dr Ben Langley, a Lecturer in Sport and Exercise Biomechanics at Edge Hill University who presented on the throwing shoulder in cricket and Dr Wotherspoon, a Consultant in Sport, Exercise & Musculoskeletal Medicine and previous Medical Officer England Cricket Team who discussed cricket shoulder injuries. Fellow London Shoulder Specialist surgeon Steve Corbett also joined the panel to present on surgical options for instability lesions.

Rowing and shoulder sport injury examined

Later on day one, the focus turned to the rowing shoulder. Chaired by two of our shoulder specialists, Susan Alexander and Andrew Wallace, discussions ranged from treating the para-rower, returning to rowing after injury and Ali Narvani presented on rotator cuff injuries and covered the surgical options available to rowers.

Tennis elbow under the spotlight

Elbow injuries in tennis were the subject of a panel on day one, chaired by Dr Jo Larkin, a Consultant in Sport and Exercise Medicine and current Chief Medical Officer for the LTA, and Ali Narvani. As well as topics such as imaging tennis-related elbow injuries and the use of conservative strategies, London Shoulder Specialist Andy Richards discussed surgical strategies for the tennis elbow.

Winter sports and shoulder sport injury

On day two, attention continued to focus on upper limb injuries, this time in winter sports in advance of the ski and snowboard season. Susan Alexander appeared on the panel to discuss ACJ and clavicle injuries and answer the question of when surgery is required.
shoulder overuse injuries

Why the shoulder is so prone to overuse injuries

The shoulder is one of the most complex and largest joints within the body. Therefore, it’s unsurprising it’s prone to a lot of different injuries. One of the most common causes of these injuries is overuse.

Here, we’ll discuss why the shoulder is prone to overuse injuries and the most common types of injuries it presents.

Why are shoulder overuse injuries so common?

The shoulder is one of the most used joints in the body and it is exposed to a lot of repetitive motions in daily use. With this in mind, it’s easy to see why overuse injuries are commonly experienced in patients.

These types of injuries can occur for a number of reasons. The overuse of the shoulder can lead to inflammation of either the fibres within the joint or the sac which cushions the joints. They can also be brought on by repetitive overhead arm movements, or through muscle strain.

While overuse injuries can occur through daily overuse, it’s typically athletes who are most susceptible to these types of injuries.

What types of shoulder overuse injuries can present?

There are three main injuries which can present due to overuse of the shoulder. These include:

If the muscle fibre becomes torn, it’s classified as a strain. If it’s the ligament that’s torn, it will be classified as a sprain. Both of these injuries have differing levels of severity, ranging from grades 1 to 3. If the injury is classed as a grade 3, it means the tissue has been completely ruptured.

Patients who have existing shoulder injuries or who repetitively lift can suffer with Bursitis. This is where the small Bursa sacs which lubricate and cushion the bones, ligaments and tendons, becomes inflamed. Occasionally, it can also be brought on by a direct hit to the shoulder.

Finally, Tendinitis occurs when the tendon sheaths of the shoulder become inflamed or irritated. Overuse causes a lot of friction which irritates the sheaths. Lifting weights which are too heavy or putting excessive strain onto the tendons can lead to this type of injury.

Study reveals sports specialisation in young athletes to be a key issue

Thanks to huge sporting events such as the Olympics, more young people are getting into sport than ever before. While this is largely a positive thing, a new study has highlighted the dangers sports specialisation presents in young athletes.

The ‘Growing Up Today’ study, analysed data from 10,138 young athletes in the United States. Interestingly, it discovered that young female athletes partaking in sports specialisation were at an increased risk of developing an injury. It also found that those specialising in one sport had an increased level of activity.

The results of the study clearly show that partaking in one sport excessively does increase the risk of overuse injuries. Therefore, athletes need to be aware of the risks involved when failing to give the shoulder adequate rest or pushing themselves too hard.

If you suspect you have an overuse shoulder injury, book a consultation with a specialist today. The earlier you seek treatment, the less impact the injury will have on your life, work or sporting opportunities.

To book a consultation with the London Shoulder Specialists, call +44 (0) 203 195 2442.

stem cell therapy for treating shoulder injuries

How useful is stem cell therapy for treating shoulder injuries?

Shoulder injuries, particularly to the rotator cuff, can be very painful, debilitating and also slow to heal as many professional athletes can attest. Speeding up shoulder injury healing has been the focus of much research and one particular type of treatment that has received a lot of attention in recent years is the application of stem cell therapy to promote shoulder healing.

While there has been a proliferation in clinics offering stem cell therapy for the treatment of a wide range of soft tissue and joint injuries, is it really a good treatment option? Here, we’ll look at whether or not stem cell therapies are truly useful in the treatment of shoulder injuries.

What are stem cell therapies?

Stem cell treatments and therapies have been a popular area of research for a wide variety of conditions. For years, they have been used in a range of settings such as growing skin stem cells for skin grafts, and blood stem cells to combat diseases.

The patient’s own stem cells are harvested – either from fatty tissue or bone marrow – and then delivered into the affected area; the theory behind the science is that your body’s own repair mechanisms are used to promote healing.

During the healing process, it is thought that the grafted stem cells are able to differentiate into specialised cells, whether that is muscles, tendons, cartilage or bone, depending on the nature of the injury. They also cause other important cells and growth factors to flood the site of the injury, repairing and regenerating the damaged tissue.

In terms of shoulder treatment, stem cell injections are provided into the affected area. There is no standardised approach and clinics will differ in terms of how the procedure is performed, but generally, it is carried out using image guidance and it’s a minimally invasive treatment. The stem cells are harvested from the patient’s fatty tissue or bone marrow, before being separated and consolidated and injected into the shoulder.

Stem cell therapy is largely used to treat partial tears and minor to moderate injuries. If the injury is severe or there’s a full tear, the only effective treatment option would be surgery.

Studies reveal little evidence to show these therapies work

There have been two crucial studies published recently within the Journal of Shoulder and Elbow Surgery. Both reveal there is actually little evidence to suggest stem cell therapies work.

Clinical data to support the claims of the effectiveness of stem cell therapies is limited. Furthermore, there appears to be a lot of patient-specific factors which can contribute towards the effectiveness of these therapies. These include medications, age, sex and genetic factors.

The studies concluded that although these treatments have great potential based upon laboratory studies, a lack of clinical data for their use in shoulder treatments is extremely limited.

Why are stem cell therapies in shoulder treatment controversial?

At the moment, stem cell therapies within shoulder treatment are considered controversial. This is because of a couple of factors, including the fact that there’s little evidence to back up their effectiveness.

These treatments are costly, and many medical insurance policies don’t cover them. This can be an issue for patients who want to undergo the procedure.

As the results are unproven, it also means that patients could be delaying the treatment they need. If they undergo the injections which ultimately aren’t effective, the injury could become worse. This would then mean they need to undergo more invasive treatment, often surgical, to rectify the problem.

At the London Shoulder Specialists, while we always stay abreast of the latest developments and we are keeping a close eye on the potential of stem cell therapy in the treatment of shoulder injuries, we advise patients to understand the limitations. With very little clinical data to support the effectiveness of these treatments, more recognised and proven techniques should first be considered. If you’re suffering from a shoulder injury, book a consultation with a specialist today. They will be able to diagnose the problem and recommend the best course of treatment.

To arrange a consultation with the London Shoulder Specialists, call +44 (0) 203 195 2442.

SHOULDER FRACTURE TREATMENT

Shoulder fracture treatment: surgery vs sling 

Shoulder fractures can be particularly painful, limiting movement within the arm. Depending upon the severity of the fracture, surgery tends to be the most common shoulder fracture treatment option. However, could wearing a sling be just as effective?

Here, we’ll look at surgery for shoulder fractures versus wearing a sling. 

Study reveals slings just as effective at treating fractures

A recent study carried out by the Aarhus University in Denmark, has revealed that slings are just as effective at healing shoulder fractures as surgery. Together with departments from Sweden, Finland and Estonia, the researchers studied 88 patients with shoulder fractures over the age of 60. 

The patients were followed for two years, with half receiving surgical treatment and the other half given a sling during recovery. The results showed no difference in improvement between the sling and the surgical groups. The patients who underwent shoulder surgery didn’t experience any less pain or improvement in movement than those who wore a sling. 

This shows that surgical treatment is unnecessary in the case of bone displacement fractures. As it doesn’t provide any improvements compared to wearing a sling, the study highlights that surgery shouldn’t be the first course of action when treating fractures.

When might shoulder surgery be needed?

While the majority of shoulder fractures could heal just as well in a sling, there are exceptions where surgery may be required. 

If the rotator cuff is damaged during the trauma to the shoulder, surgery may be the best option. This is because rotator cuff tears, in particular, don’t tend to heal by themselves. It does depend upon the severity of the tear, but usually, patients do require surgery to fix it.

Each shoulder fracture case should be looked at independently to assess whether or not surgery is required.

Will the results change the clinical shoulder fracture treatment approach?

The researchers behind the latest study are hoping the results will alter clinical treatment approach. It clearly shows that surgery doesn’t improve the outcome compared to wearing a sling. 

As with any surgery, shoulder surgery for treating fractures comes with a number of risks and complications. It also requires a sometimes-lengthy recovery process. So, if the same results could be experienced by the patient wearing a sling, it would eliminate these risks and be much better for the patient’s wellbeing.

This was a fairly small-scale study. Therefore, more in-depth, larger studies may be required to fully change the opinions of surgeons. It’s also important to note that the patients in the study didn’t have damage to the rotator cuff. So, while wearing a sling may be just as effective as surgery in shoulder fractures, if there are any accompanying injuries, surgery may be preferential.

Those who do suspect they have a shoulder fracture, should seek a diagnosis from a shoulder specialist. They will be able to determine the severity of the injury and whether or not surgery will be required. This latest study does prove useful for shoulder specialists, enabling them to make better shoulder fracture treatment decisions for bone displacement fractures.

Cricketing shoulder injuries

Play on and prevent cricketing shoulder injury 

As an eventful and often nail-biting summer of cricket comes to a close with England securing a 2-2 draw in the Ashes yesterday, the London Shoulder Specialists explains why the shoulder is so susceptible to being injured in cricket.

Like any sport, cricket poses numerous injury risks. One of the most common is overuse and injury to the tendons and muscles of the shoulder. This type of injury can be painful and if left untreated, lead to months out of the game. However, there are ways to prevent cricketing shoulder injuries.

Here, we’ll look at the most common cricketing shoulder injuries and how they can be prevented.

Common cricketing shoulder injuries

Cricketers are at risk of numerous cricketing shoulder injuries. The most common of these being rotator cuff tendonitis and impingement syndrome.

Rotator cuff tendonitis occurs due to a repetitive throwing action in cricket. The tendons around the rotator cuff swell, causing pain and limited movement. Impingement syndrome, otherwise referred to as cricketer’s shoulder, is typically triggered by rotator cuff tendonitis. The swollen tendons end up trapped within the subacromial space.

The symptoms for both of these injuries are similar, and treatment typically requires rest, physiotherapy and depending upon the severity of the injury, surgery. If left untreated, inflammation is likely to continue to develop, 

Problems can also occur with the labrum which is a ring of tissue around the socket of the shoulder. 

Does cricketers shoulder differ from throwing shoulder?

Cricketer’s shoulder is often referred to as throwing shoulder. However, a recent study has revealed there are differences between the two conditions. 

The study included 106 elite cricketers from South Africa and consisted of numerous tests, measurements and questionnaires. Results showed that the musculoskeletal profile of the cricketer’s shoulder is different from that of thrower’s shoulder.

Two risk factors of cricketer’s shoulder were identified in the study. These included a shortened non-dominant pectoralis minor muscle and a thicker dominant supraspinatus tendon.  

How can cricketing shoulder injuries be prevented?

While cricketing shoulder injuries are a high risk for professional athletes, there are ways to limit the risks. One of the main thing patients can do is strengthen the shoulder and back muscles.

There’s a lot of different exercises you can do to strengthen the muscles and tendons. Ideally, you’ll want to seek advice from a shoulder specialist or physiotherapist as to which exercises would be better for you. They’ll be able to take into account the amount of time you play cricket and the level at which you play at. This will enable them to recommend specific exercises which may help you. 

Ensuring you rest adequately between matches is also recommended. The shoulder needs time to rest and heal. The majority of shoulder injuries in cricketers occur due to overuse. So, allowing time between matches to rest the shoulder will greatly reduce the risk of injury. 

Cricketer’s shoulder can be painful and if left untreated, it could lead to significant time away from the sport. As soon as you feel pain within the shoulder, it’s important to seek a diagnosis. The earlier an injury is treated, the sooner you can get back to being on top of your game.

shoulder tendon repair vs physiotherapy

Tendon repair more effective than physiotherapy for rotator cuff tears

A new, large-scale study has revealed that shoulder tendon repair surgery is more effective in the long-term than physiotherapy for rotator cuff tears. Although surgery is often used as a last resort, this study clearly highlights its benefits for long-term success.

Here, we’ll look at the results of this latest study and the surgical repair options available to treat rotator cuff tears.

Shoulder tendon repair more effective for small and medium tears

The study, which used a ten-year follow-up to produce its results, showed that tendon repair could be more effective for small and medium tears. The researchers analysed data from a total of 103 patients. Each had rotator cuff tears which were a maximum of 3cm.

The 103 patients were randomly chosen for either physiotherapy or primary tendon repair. Follow-ups were then conducted at six months, one year, two years, five years and finishing on the 10th year. The follow-up data looked into patient satisfaction, shoulder pain, and strength and motion.

It was discovered that the efficiency of treatment was higher for patients who underwent tendon repair. In all of the follow-ups after the surgery, the function of the shoulder was reported as stable. However, in the patients who underwent physiotherapy, stability of the shoulder was shown to actually decline. At the ten-year follow-up review, tendon repair had the best scores overall in terms of pain, mobility and stability.

Although this study only focused on small and medium rotator cuff tears, it does show the benefits early surgery could provide.

When is surgery recommended for rotator cuff tears?

At the moment, surgery is used as a last resort to treat rotator cuff tears. Non-surgical methods are attempted first, particularly if the tear is small or medium in size. However, it is known that unrepaired tendons actually widen over time, resulting in a need for more invasive surgery later on.

Patients usually need to wait six months to a year before surgery is recommended. The only exception to this is if the rotator cuff tear is large or if there is a significant weakness within the shoulder and arm.

The surgical options available

There are a number of surgical options available to repair a rotator cuff tear. The type of surgery used will depend upon a number of factors such as the severity of the tear and the quality of the bone and tendon.

The three most common surgical options include open repair, all-arthroscopic repair and a mini open repair. If you are suffering from a rotator cuff tear, you’ll be advised which treatment option would best fit your circumstances.

Overall, rotator cuff tears can be extremely painful, and surgery is usually used as a last resort. However, this latest research shows the importance of early surgery to provide better long-term outcomes for patients. Those who are suffering from a rotator cuff tear should book a consultation to determine its severity and the best course of treatment moving forward.