Last summer, pain in his shoulder sidelined his golf game. This summer Dr. Adrian Baddar’s patient is back swinging the sticks and doing other activities he loves, thanks to a successful rotator cuff repair.
Baddar, of Hampton Roads Orthopaedics and Sports Medicine, with offices in Newport News and Williamsburg, first saw the man last summer. The patient, who was in his 60s, had been treated somewhere else for about a year—following the standard conservative initial approach of anti-inflammatory medication, physical therapy and injections.
Since this treatment hadn’t solved the problem, Baddar ordered an MRI and found the man had a large tear in his rotator cuff—the tendon that stabilizes the shoulder joint. Rotator cuff tears are one of the most common shoulder ailments, he says. Because it has a limited blood supply, the rotator cuff is prone to injury and has a limited ability to heal itself.
Like his fellow sufferers, this patient’s main complaint was pain, especially at night. But he also had trouble using his shoulder, hence the dusty golf clubs.
“Most times, when we use our arms we’re doing things at waist level, such as typing on a keyboard,” Baddar says. “It doesn’t require use of our shoulder. Not until we start being more active or reaching overhead like trying to play tennis or golf do we notice we have only limited function. Then when we get into bed, the shoulder stiffens up. But any motion hurts, and we’re constantly waking up from the pain.”
The outpatient surgery took about an hour. Baddar accessed the muscle through three tiny poke holes, cleaned out the inflammation, fixed the rotator cuff via what’s called a double-row repair—using four anchors to hold the tendon onto the bone.
“That puts the rotator cuff in a position so it can heal,” Baddar says.
In six to eight weeks, the tendon had grown into the bone, and the patient completed a couple more months of physical therapy to strengthen the rotator cuff.
“Initially, all we let them do are activities that don’t use the shoulder,” Baddar says. “They can type, play on an iPad, read the paper and brush their teeth with their elbow at their side. By the second month, people hopefully can sleep through the night. By the fourth month, people have enough strength to do their day-to-day activities. This patient was an early healer. He was out of his sling in two weeks and was doing pretty well by four months.”
If you’re having problems with a shoulder, gutting it out is not the answer. Since the rotator cuff won’t usually heal itself, any tear typically gets worse.
“The tear can cause the muscles to waste away to the point you cannot repair them,” Baddar says. “It’s not something you want to put off for years. You can burn a bridge by waiting too long to get it fixed. At that point, the only thing you can hope for is a reverse shoulder replacement.”
Because he got the right treatment in time, Baddar’s patient is playing golf by day and sleeping well at night.