Do I Need Rotator Cuff Surgery?
Shoulder Surgery is a Last Resort
Not every rotator cuff condition requires surgery.
It's generally understood by doctors and surgeons that surgery will introduce more scar tissue into your shoulder. This added scar tissue will be problematic, requiring physical therapy and often significant treatment post-surgery. If not dealt with properly, your shoulder could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.
If You Haven't Done So Yet, Get a Proper Diagnosis
A serious rotator cuff tear is termed as Surgically Necessary (SN) and will require surgery, and in cases of complete tears or detachment, there is really no other option. This is why it is important to get to a physician and find out what is really going on - this is known as getting a proper diagnosis. Getting a proper diagnosis would also determine if your shoulder pain is a side effect from another condition or disease (diabetes or lyme disease are two examples). This is less common but nonetheless, very serious. So yes, it is important to get a proper diagnosis.
The Good News
Most rotator cuff injuries are not Surgically Necessary, and will heal on their own. This is why most doctors, physicians and orthopaedic specialists will recommend conservative therapy for non-SN rotator cuff injuries before considering surgery.
Some of the most effective conservative treatment methods to avoid surgery are:
- Rest - This is important for initial healing to reduce pain, swelling and inflammation in the early stage of your rotator cuff injury. Too much rest can also be harmful to shoulder injuries because joint immobility of the shoulder can actually cause stiffening in the shoulder joint. This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.
- Avoid Activities that Caused Your Injury - While resting your shoulder it's also important to avoid all activities that may have caused your injury in the first place and this definitely includes pretty much any type of sport where your upper body is involved. Continuing on with regular activities will not only make your injury worse, but limping to 'work around' your injury will eventually give rise to over-compensation injuries in other areas of your body.
- Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation - use at the onset of the injury and during flareups.
- Use a Shoulder T•Shellz Wrap® - You can use your own blood flow to maximize your rehabilitation, maintain healthy blood flow to your shoulder, decrease recovery time, and reduce re-injury risk.. Promoting blood flow and using a warming treatment for your shoulder will help to minimize the growth of scar tissue and help increase flexibility. This is why we recommend TShellz Wrap before undergoing activity - an increase in flexibility should help reduce risk of further injury.
- PT - Surgery is usually the last resort. This means doctors or surgeons typically won't perform a surgery until they feel that their patient has put effort into treating their injury with conservative treatment methods. This includes 4 to 6 months of visits to a physical therapist. If you haven't experienced any improvement in your condition during that time then surgery may be considered. Agressive PT approaches will focus on forced or manual manipulation of your shoulder joint - this means your physical therapists will be trying to move your shoulder past the point where it 'sticks' or is 'frozen' in place. This can be painful and end up making your injury worse if not done correctly. (reference: 1)
- Stretching - Stretching your shoulder in PT and at home will help you to regain your range of motion much faster than not stretching the shoulder joint at all. Stretching in many ways is key maintaining good Range of Motion (ROM) in the shoulder, and stretching can be made much easier with use of a TShellz Wrap before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to prevent any return of swelling and inflammation.
For acute (new or recent) shoulder injuries that have the ability to heal on their own - your doctor may even suggest use of a removable shoulder sling. A removable sling can be very helpful to prepare you for physical therapy sessions and mobility exercises.
However, prolonged use of a removable shoulder brace or long-term rest (restricted movement) without proper exercise or stretching can make your shoulder condition worse. If your shoulder remains completely immobilized and at constant rest, the edges of your soft tissue tear will begin to fill in with scar tissue as part of the healing process. You may also have on-going symptoms of pain, swelling, inflammation, and even poor blood flow circulation.
Be Careful About Cortisone
Steroid injections can provide temporary relief from the pain of tendon related injuries and are very popular. However, these injections should generally be avoided if possible as they weaken the tendon and may lead to a rupture. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.
"In other words, in some way, the cortisone shots impede full recovery, and compared with those adopting a wait-and-see policy, those getting the shots 'are worse off'. Those people receiving multiple injections may be at particularly high risk for continuing damage. (reference: Reynolds, G. (1288). Phys Ed: Do Cortisone Shots Actually Make Things Worse?. Well. Retrieved 17 November 2016, from website)
"Complications of cortisone shots can include:
"Risks - Cortisone Shots - Mayo Clinic". 2016. Mayoclinic.Org. Accessed November 17 2016. website
- Joint Infection
- Nerve Damage
- Thinning of skin & soft tissue around injection site
- Temporary Flare of Pain & Inflammation in the Joint
- Tendon Weakening or Rupture
- Thinning of Nearby Bone
- Death of Nearby Bone
- Temporary Increase in Blood Sugar"
What Happens When You Are Not Using Conservative Treatment Methods (as Outlined Above)
Soft Tissue Injuries of the Shoulder (this also includes the rotator cuff) are all injuries that cannot really be ignored. If you choose to ignore the injury, then this means you will still be be trying to do certain tasks (ie. using a fork, putting on your seat belt, etc) using soft tissue (strained and/or partially torn ligaments & tendons) that is already compromised. This means it will inevitably get worse.
Here is what to expect:
- Since the tissue is still inflamed, lack of proper blood flow will drop your healing rate to a crawl.
- Continually straining the soft tissue (just by doing daily tasks such as cooking and sleeping on your side) worsens the injury and will introduce more scar tissue.
- Increased scar tissue buildup will tighten the soft tissue in your shoulder, decreasing your already limited flexibility.(reduced range of motion)
If you suffer from a rotator cuff injury, this means that when you get out of bed in the morning and try to bathe, shave or wash your hair, it will hurt a LOT - this is due to reduced flexibility in the shoulder.
Since the ligaments/tendons of the shoulder cannot flex as much as they once did, trying to use it during your simple daily routine just introduces more scar tissue and continuously worsens the injury. As you can see this is a cycle that just gets worse and worse, eventually becoming a chronic (long term) injury. This is the cycle you need to stop or you will probably wind up having surgery once your injury becomes chronic.
What Are the Two Biggest "Gotchas" When Treating My Rotator Cuff Using
Conservative Treatment Methods?
The Absence of Pain Does Not Mean Your Injury is Gone
After most of our clients use a Cold Compress or Ice Pack as instructed, shoulder pain disappears very quickly. This where most people wrongly associate the pain with the injury, whereas in truth, almost all of the pain really came from the inflammation and swelling. Once the inflammation is gone, do not assume you are fully healed.
Time Is Not Your Friend
So you have used cold compression and most of the pain is gone, but it's been a couple of months and the injury keeps flaring up. If this is you, then you probably know why this is happening now... the injury was never fully healed. To really heal a shoulder injury, cold compression is helpful - but you really need to rest until it is healed, and you don't need me to tell you this is a pain in the butt! This is why we feel the Shoulder TShellz Wrap is such an important tool. It is intended to augment your body's ability to heal; if you can recover quickly, you are more likely to avoid getting into a chronic re-injury cycle.
Once the initial swelling has decreased, you can provide pain relief and improve your arm function by using an T•Shellz Wrap® to increase the blood flow to the area. Gentle massage around the injured area or small shoulder movements (if not painful) will also help increase blood flow, oxygen and nutrients and will prevent stiffness. We also highly recommend that our clients treat themselves with the Circulatory Boost wrap first thing in the morning before getting out of bed. This is important, as heat is known to increase elasticity and flexibility of soft tissue; flexible soft tissue will be less likely to strain and tear at their most vulnerable time - after a long period of inactivity.
Why Your Rotator Cuff Injury Won't Heal
If our body is designed to heal our own injuries, why does it take so long to heal?
When we have an injured ligament, muscle, tendon or bursa, this means the tissue and cells are damaged. Your body responds to this damage with healing right away. During this healing process the injured tissue spasms. These spasms are contractions, and are meant to hold the tissue still to prevent any further injury.
Swelling and inflammation is your body's way of:
- Creating localized pain to tell you something is wrong there and to stop moving it, and
- Sending blood to the area to start healing. Healing at this point will also expand the blood vessels in the injured tissue - they enlarge and swell causing you pain. This pain is a signal for you to lessen activity that would put anymore undue stress on your shoulder.
However, there are significant problems with swelling and inflammation when it comes to the body's healing rate. Once soft tissue (such as your supraspinatus tendon) is inflamed, blood-flow is restricted. The body heals itself by sending nutrients through the blood to the injured tissue, and if the injured tissue is swollen, the blood-flow is greatly decreased.
Decreased blood-flow to injured tissue prevents the damaged tissue from healing as fast as it would if the area wasn't swollen.
The other issue is that swelling is also very painful. With many conditions such as the common supraspinatus tendinosis, once you get rid of the inflammation, a lot of the pain will disappear as well.
Once the Pain is Gone, We Think Our Soft Tissue Injury is Healed.
So we start using it more and more for common tasks, and then "boom" we get a sharp pain and then it starts all over. When this happens, the injury was never fully healed - and now it is worse! More scar tissue grows in the new tissue micro-tears and well, lets talk about scar tissue.
Scar Tissue - We Need It For Kick-Starting Tissue Tear Repair
But After That It is Nasty Stuff
Tendons, ligaments, muscle and other soft tissue in the shoulder are all meant to be soft and flexible, ready to work and move extreme forces in everyday activities. When I say extreme force, I mean try to imagine the amount of force that your arm puts on your shoulder, even when you are just trying to lift your own arm, let alone something heavy.
Scar tissue grows in damaged tissue when it tries to heal; little tiny band-aids that overlap each other to bind tiny tissue tears together. With this added scar tissue, muscles & tendons & ligaments become rigid, less flexible and unable to handle the forces that it once could. If you're suffering with scar tissue now you may feel the effects with stiffness, tightness, weakness and tiredness in your shoulder.
Scar tissue can form fast to bring together the edges of a tear, but working fast doesn't mean that the job's done right. When scar tissue forms it doesn't come together as neatly as regular (healthy) tissue would. Scar tissue fibers will lay down over top of your tear in a cluttered, messy and jumbled up way.
On-going issues with scar tissue can result in soft tissue tears and increase chances of strain to nearby tendons or ligaments (as they are now handling higher forces due to overcompensation).
Scar tissue is one of the MAIN reasons why a chronic shoulder injury has not healed and your Range of Motion (ROM) is reduced from what it once was.
Scar tissue will also attach to everything in the area, including the surrounding healthy tissue. This can result in a fusing together of the soft tissue in the shoulder that shouldn't be fused together, and this will cause extreme pain when you move your shoulder - it is literally ripping scar tissue. This is why physical therapy is often painful - the therapist stretches the joint, forcing the scar tissue bonds to break so you can regain your range of motion.
Scar tissue is a major problem especially when it comes to a shoulder injury - causing your injury to become chronic, and taking months or even YEARS to completely heal!
To reduce scar tissue growth, prevent further injury to the area; this is done by increasing blood flow to the area and using a warming treatment to increase flexibility and length of these tissues (this makes them less likely to injure or tear further). In our opinion, treating yourself with a Shoulder TShellz Wrap is an easy, effective way to help assist in your home recovery process by reducing risk of re-injury and minimizing growth of stubborn scar tissue.
When applied before activity or work, the TShellz Wrap will relax and lengthen soft tissue in the treatment area to help improve your range of motion and prevent atrophy (tissue wasting & shortening) of your injured shoulder.
Overall, continued treatment with a TShellz Wrap is intended to maintain good health in your soft tissue and significantly reduce your risk of re-injury.
Have you seen what happens when you add water to a flower wilted from drought? In essence, your injured shoulder is much like a "wilted" flower; your body wants to heal its injury, but needs lots of nutrients to do it. Blood brings new life to your cells by delivering healing nutrients and oxygen that are vital to your tissue. In addition, the blood carries away toxins and cellular waste - cleaning the area and healing it faster. Without a good supply of blood, your shoulder simply won't heal properly.
Using a T•Shellz Wrap® will not expose you to the risk of causing further harm to soft tissue like you can when using rigorous exercise. The Shoulder T•Shellz Wrap® accomplishes the goal of enhanced blood flow without the need for intensive exercise and as such reduces your risk of re-injury.
When to use a Shoulder TShellz Wrap:
- Once the swelling is gone (usually after applying cold compression to the injury over 24 to 72 hr period).
- BEFORE getting out of bed in the morning. BEFORE going to bed at night.
- BEFORE exercise, workouts or activity of any kind to increase elasticity of shoulder tendons, ligaments and muscles and decrease the chance of re-injury.
- AFTER surgery (once the skin wound has healed over) to boost blood circulation, helping surgically repaired tissues rebuild for long-term health and minimize scar tissue growth at the surgery location.
- Anytime BEFORE you feel you might undertake activity that will put significant strain on the injury area.
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Minimize Your Chance of Shoulder Surgery with Effective Conservative Treatment Options
If your doctor thinks you might be able to avoid surgery by using conservative treatments, you can join our many customers who have had great success treating themselves with the powerful treatment products we offer through AidMyRotatorCuff.
Rotator Cuff Tendinitis or Tears, frozen shoulder, shoulder impingements and soft tissue shoulder injuries are not uncommon - it can happen to anyone. Right now, there are thousands of doctors and physical therapists dealing with patients that require a solution to heal their injury as fast as possible. Maybe they are just patients that are unwilling to just take pain pills, lay in bed and wait or perhaps they are patients with extensive access to medical care with a great insurance plan. Even fortunate patients such as this have greatly benefited from boosting their PT and medical treatments with home therapies using the products we have recommended.
Regardless of who you are or your reasons, if you want to be proactive about properly addressing your shoulder condition and minimizing the negative impact it will have on your lifestyle, talk with your physician about incorporating the use of a Shoulder T•Shellz Wrap® in your conservative home recovery plan. We have many happy customers that have recovered from their injuries faster than even they had hoped for, and significantly reduced their pain during treatment and through the healing process.
The Next Step Is Up To You!
Living with pain is never easy as it affects your entire lifestyle. Living with pain during or after an intensive surgery and lengthy rehabilitation period can be even harder! What is more important than making good decisions when confronted with rotator cuff pain.
Doctors and Surgeons are always improving the technologies used in surgery, and results from surgery now are much more positive than they were in the past. However, all surgeries introduce scar tissue, and recovery from shoulder surgery is often disappointing. If you do wind up getting surgery, know that rehabilitation at-home while attending regular PT or doctor appointments is vital for your overall recovery. It is especially vital to the shoulder and knee areas, as they consistently handle extreme forces (body weight). Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor, surgeon or physical therapist is key - and this is why you should seriously consider maximizing your recovery by using the Shoulder T•Shellz Wrap® at home once you are approved for PT.
AidMyRotatorCuff.com stands out in this regard as our goal is to help you keep your shoulder healthy for the long-term in a cost effective manner. This might mean a rotator cuff recovery at home without the need for surgery. If you couldn't avoid surgery, then you may find our products to be very helpful during your recovery period.
We strongly believe that we can help you, and we have thousands of happy clients to back this claim. You are welcome to try our products for a 60 day period. If you are committed to following the treatments outlined in the product instructions we are very confident that our TShellz Wraps will aid you immensely. If you do not receive the benefits that countless of our other customers have experienced from our products, call us, mail the product back to us and we will provide you with a full product refund.
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We also encourage your to Call Our Office at 1-866-237-9608 (toll free continental NA) where we can answer any questions you have and/or take your order via phone.
Our customer service lines are open 5 days a week helping people understand their injuries and how to treat them. Simply call toll free 1-866-237-9608 to talk or place an order with one of our knowledgeable Product Advisers. They have the ability to answer questions and even put together a treatment plan for you.
The bottom line is, you are welcome to try our products for a full 2 months. If you do not receive the benefits that others have experienced, simply call us, then return your purchase back to us and we will issue a prompt & full refund. There will be no hard feelings.
AidMyRotatorCuff advisors do not work on commission, so be assured you will only receive fair and objective information about your condition and how our products can help you.
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Learn More About The Rotator Cuff
Learn more about Shoulder Surgery and Post-Surgery Recovery
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Learn more about which is better for your rotator injury - ice or heat
During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!