I. What is the rotator cuff?
The rotator cuff is a tissue consisting of four muscles and tendons inside the shoulder joint, like a cuff covering the upper end of the humerus. It plays an important role in the movement of the shoulder joint in all directions, and its role is similar to that of a hanger for building a house.
B. What are the conditions that make rotator cuff injury easy to occur?
Trauma to the shoulder (such as a car accident injury); throwing activities like baseball throwers; chronic injury caused by subacromial impingement.
What are the signs of rotator cuff injury?
Pain in the shoulder, especially at night; inability to lift the upper limb and weakness; reduced range of motion of the shoulder joint.
The diagnosis of rotator cuff injury is clear and most of them need surgery. At present, rotator cuff repair surgery under shoulder arthroscopy has been widely carried out, which has the advantages of less surgical trauma and faster recovery.
IV. Treatment process.
The doctor in charge will understand your condition in detail and ask you to tell the truth about the development of your disease and your past medication use, especially the history of drug allergy.
Before surgery, you need to complete the relevant procedures, including the patient’s power of attorney, informed consent for surgery, informed consent for the use of disposable materials, and informed consent for anesthesia. Please read them carefully and have them signed by the patient or the delegate.
On the night before the surgery, sleeping pills may be given before bedtime to eliminate preoperative tension. Also, no food should be eaten from 6 hours before to 6 hours after surgery. It is also recommended that you take a shower before surgery and try to keep your whole body, especially the skin near the incision, clean.
Before entering the operating room, please leave your valuables and movable dentures with your family for safekeeping.
After you enter the operating room, the anesthesiologist will place an intravenous line in your other arm or leg to administer medication during the procedure. The surgery is usually done under general anesthesia.
After the surgery, you will be taken to a recovery room where you will gradually regain consciousness. The anesthesiologist will stay with you and encourage you to cough or breathe deeply to cleanse your lungs. Once you are fully awake, you will be escorted back to your room by the anesthesia staff.
This is due to the continuous flushing of the joint cavity with saline during the arthroscopy. Some fluid may have entered the tissue spaces around the joint.
V. Rotator cuff injury rehabilitation exercises
1.0-2 weeks after surgery
Use a brace to keep the shoulder joint in a mild external booth. On the 1st day after surgery, start active activities of the elbow, wrist and finger joints, and gradually increase the time and number of activities. On the 2nd day after surgery, start passive activities of the shoulder joint, and it is appropriate not to cause pain.
2.2-6 weeks after surgery
Rotator cuff tears larger than 1cm still need to be protected with braces. Perform shoulder joint swing and circle exercises without causing shoulder pain. Do backward and forward, left and right oscillation and clockwise and counterclockwise circling exercises in as wide a range of motion as possible. Active shoulder joint activities were prohibited for 4 weeks after surgery, and after 4 weeks, the passive range of motion of the shoulder joint could be gradually increased so as not to cause pain. Perform wall climbing exercises within the pain-free range, 15-20 strokes each time, twice a day. 2-4 weeks after surgery, the elbow joint can be transitioned from passive to active motion. At 2 weeks postoperatively, shrugging motion exercises are started, (joint inactivity). 6 weeks after surgery, start the active movement exercise of shoulder muscles, but should avoid doing the strength exercise to abduction.
3.6-12 weeks after surgery
At 6 weeks after surgery, start active shoulder movement and gradually increase the range. The exercise can be assisted by equipment. At 10 weeks postoperatively, continue active shoulder movement training within the tolerable range. At 12 weeks or gradually start shoulder abduction exercises so that the shoulder movement basically returns to the normal range. At 8 weeks postoperatively, resistance training was started, and internal and external rotation resistance training of the shoulder joint was done with the elbow flexed. Open chain training was gradually started at 12 weeks postoperatively. Muscle training should be high repetition, low load and gradual. Posture correction education and muscular endurance training should be performed at the same time.
4.12-16 weeks after surgery
Strengthen the active activities of the shoulder joint in all directions and try to make the activities of the shoulder joint in all directions close to the normal range. Continue to strengthen the strength and endurance of the muscles around the shoulder. Gradually restore the normal motion function of the shoulder joint, and at the same time, you should emphasize the continuous shoulder joint flexibility and coordination training in daily life activities.
Special reminder: For three months after surgery, patients are advised to visit the outpatient clinic for monthly review and to listen to the physician’s advice.