Ask-a-Doc:
Do I Need Rotator Cuff Surgery?

Hello, I’m Dr. Jason Hurst. 

The most important thing about understanding what a rotator cuff tear is is to first understand what the rotator cuff does. 

So, the rotator cuff is a common tendon that wraps around the ball of our shoulder. Multiple muscles—four—attach to that common tendon and compress the ball against the socket. It allows the shoulder to work perfectly central along the socket while the other muscles of your shoulder move it around. So, without a functioning rotator cuff, your ball and socket don’t work well, and you get pain. 

A rotator cuff tear is one of the most common ailments we get as we age. There are two kinds of cuff tears: the acute or traumatic cuff tear, usually the result of a bad fall, and the chronic cuff tear, which happens over time. The rotator cuff fails as a result of age, or I wouldn’t say overuse, but misuse. 

And how you treat them is vastly different. An acute traumatic cuff tear, in the vast majority of patients, should be fixed surgically. The caveats to that would be if you are a much older patient. So, older patients, and what I mean by older, is over the age of 70. 

Most of those patients would do better without surgery. With physical therapy and injections of medicines, they can get some function back. In the younger patient, you’re much more inclined to fix them in order to restore their shoulder function.

Now, chronic cuff tears, on the other hand, don’t always need surgery, either. The main thing that determines whether a patient with a chronic cuff tear needs surgery is the age of the patient, because younger patients tend to heal better than older patients, the function of the patient, and number3 is the MRI—we get lots of MRIs, especially in the shoulder, because there are certain characteristics on the MRI that predict success of repair. 

Those include how the muscle looks, how the tendon looks, and what the joint looks like. There are certain criteria that might predict that you would not do well with surgery, and therefore, we would do something conservative or non-operative. 

So, when you have a tear, it’s not that the tear always equals surgery. It depends on the type of tear, how bad it is, the age of the patient, and the function of the patient. 

A lot of times, we see patients in referral who come in really nervous that they have a cuff tear and that they’re going to need surgery. And that’s just not always the case. The shoulder surgeon at JIS Orthopedics will talk to you about all these different factors and determine if surgery is really the best option because it might not be the best thing for you.

If you want to know more about rotator cuff surgery, contact us at JIS Orthopedics. Our specialists in New Albany and St. Clairsville, Ohio, can give you the answers you are looking for. Schedule a visit with us today!