Shoulder Hurts? Arthroscopic Rotator Cuff Repair Restores Active Lifestyles

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Shoulder Hurts? Arthroscopic Rotator Cuff Repair Restores Active Lifestyles Dr. Kevin Plancher discusses new, minimally invasive technique for faster, fuller recovery

NY, NY and Greenwich, CT, March 2006 â€“ A network of muscles and tendons that hold together the shoulder and arm bones, the rotator cuff facilitates the flexibility of the shoulder, which is needed for “overhead” activities like tennis and golf, swimming and throwing a ball. In fact, even everyday functions like writing a letter or carrying groceries can prove next to impossible with a severe rotator cuff injury. Until recently, a diagnosis of a rotator cuff injury requiring surgical repair meant an invasive procedure followed by weeks, if not months, of recovery and rehabilitation, along with the risks of damage to surrounding muscles and tissue in the shoulder and arm. But new arthroscopic surgical techniques offer patients a less invasive alternative and the potential of a faster, fuller recovery. “Rotator cuff injuries are very common, particularly among fit, active â€˜Baby Boomers,â€™” notes Kevin Plancher, M.D., a leading NY-area orthopaedist and founder of the Orthopedic Foundation for Active Lifestyles (www.ofals.org) â€“ a non-profit organization dedicated to advancements in research and education for orthopedics and sports medicine. In fact, according to the American Academy of Orthopaedic Surgeons (AAOS), approximately 4 million Americans visited a physician for a rotator cuff or shoulder problem in 2003. “For the 40,000 or so patients whose rotator cuff injuries are serious enough to require surgery each year, the advances in arthoscopic techniques make both the procedure and the recovery far less daunting,” adds Dr. Plancher. Traditional approaches to rotator cuff surgery included “open” repair, in which a large incision would expose the entire rotator cuff during surgery, and “mini-open” repair. “With mini-open repair, arthroscopes would be used to guide the surgical team during the procedure, but the surgery itself would be done manually. However, the fully-arthroscopic knotless rotator cuff repair allows for the entire procedure to be done with precision through buttonhole-sized incisions,” Dr. Plancher explains. “The fully arthroscopic technique presents less risk of injury to surrounding muscle and tissue, promotes faster healing and rehabilitation, and is as effective as mini-open repair at relieving pain and restoring range of motion,” adds Dr. Plancher. In fact, two studies reported in the December, 2005 edition of the journal Arthroscopy confirm that those who undergo fully-arthroscopic rotator cuff repair report similarly positive results for both pain relief and restoration of motion in the joint as do those patients who undergo open or mini-open repairs. However, Dr. Plancher â€“ a sports medicine expert, and official orthopedic surgeon of the U.S. Ski and Snowboard teams â€“ recommends the fully-arthroscopic approach in particular for fit “Baby Boomer” patients whose goal it is to return to an active lifestyle. “The fully-arthroscopic repair involves less trauma to the rotator cuff and the surrounding tissues than do the open or mini-open approaches, and so recovery is often faster and fuller, which is important for patients whose goal is a return to the golf course, the tennis courts or even the swimming pool,” Dr. Plancher notes. “Itâ€™s important to remember that, as we age, the muscles and tendons lose a bit of their flexibility and ability to heal themselves quickly, which is a factor in both how we recover from injuries and how we end up getting injured in the first place,” Dr. Plancher adds. He encourages his patients who enjoy “overhead” sports to take several precautions in order to prevent injuries, as well as to limit the damage an injury may cause:

Practice warm-ups and stretches before and after play. Warm up with aerobic exercises such as jumping rope or brisk walking, and then stretch warmed muscles before beginning play. “Research confirms that cold, stiff muscles are more prone to injury than warm, flexible ones,” Dr. Plancher notes.
Donâ€™t play with pain. Although most rotator cuff injuries are simply small tears that will heal with rest, some do require surgery and will worsen without it. “Recurrent or chronic pain is a sign that an orthopedic surgeon should evaluate,” Dr. Plancher confirms.
Strengthen the cuff. Overhead sports enthusiasts should contact their sports medicine physician or orthopedist for specific exercises that can build strength in the muscles of the rotator cuff. “These are targeted exercises not typically done at a gym or in a home strengthening routine,” Dr. Plancher says, “but they can help prevent serious rotator cuff injuries.”

“Most importantly, if you suspect an injury to the rotator cuff, see an orthopedic specialist for evaluation immediately,” Dr. Plancher urges. “If surgery is required, patients should discuss the benefits of a fullyarthroscopic approach with their surgeon.” Because fully-arthroscopic rotator cuff repair is a relatively new approach, many surgeons may choose an alternative technique, Dr. Plancher adds. Visit www.aaos.org to find a surgeon specializing in the technique, or contact Dr. Plancher at www.plancherortho.com.

Shoulder Hurts? Arthroscopic Rotator Cuff Repair Restores Active Lifestyles

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