Mr Harry Brownlow

BSc (Hons), MB ChB (Hons), MD, FRCS (Eng), FRCS (Tr&Orth)

Consultant Orthopaedic Surgeon

Circle Reading Hospital

0118 922 6888

Rotator cuff tears

Night pain is a major feature of rotator cuff tear, and this can have a knock-on effect on your quality of life. If you’re being woken every night by your shoulder pain, it can be very frustrating, as well as exhausting.

Many people with a rotator cuff tear will find that their shoulder hurts when they try to do anything at or above shoulder height. With your arms down by side (for example, carrying a tray close to you), you would probably have no pain at all, but if you tried to lift something moderately heavy down from a high shelf, it might really hurt. You may even find it impossible to do so as the pain is too severe.

Even a relatively trivial injury can have a big effect. For example, I saw a gentleman the other day who had torn his rotator cuff while playing golf. He had hit a bad shot when he felt a searing pain in his upper arm usually. A simple thing like a golf swing, and it tore his rotator cuff.

Some of the symptoms of a rotator cuff tear can also been seen in other shoulder problems. If you have pain in or around your shoulder, I always recommend you seek expert help.

There are a number of treatment options for a rotator cuff tear, and these will depend very much on the extent of the tear and the severity of your symptoms.

As a first line treatment, it’s always best to start with a simple painkiller or anti-inflammatory for a short period, if you can tolerate it. These can often make the pain more manageable, although the underlying cause of the problem will still be there.

Physiotherapy can be a really helpful in the management of rotator cuff tears, although sometimes people find it is too painful for them to do. Our Circle physiotherapists can help you with the correct exercises and movements.

If medication and physiotherapy are not as effective as you would like at relieving your symptoms, you may consider having a cortisone injection into the shoulder. This has both a pain relieving and an anti-inflammatory effect. Most people will experience pain relief for several weeks, during which time physiotherapy can be carried out. The effects of a cortisone injection will eventually wear off over time. They can be repeated, although often additional injections can have less of an effect.

If we have tried all these treatments but your shoulder is still troublesome, I would usually perform an ultrasound scan of your shoulder there and then, as this will tell us everything we need to know about the cause of your pain. Ultrasound is excellent as showing soft tissues and can help determine the extent of any tears in the tendons and muscles of the shoulder.

If the ultrasound scan confirms a tear in your rotator cuff, we can do a rotator cuff repair. This is a day case procedure, meaning you will be able to go home the same day. Rotator cuff tear is done arthroscopically. Arthroscopy is a form of keyhole surgery; only a few very small cuts are made into the shoulder and then any repairs needed are carried out using very small surgical tools.

Following your surgery, your arm will need to be in a sling for around three weeks and then you will follow a program of rehabilitation. Rehabilitation is slow. Usually, after around three months your shoulder will definitely feel better, but it still won’t be quite right; after around six months, your shoulder should feel really good again.

 

If you think you might have a rotator cuff tear, why not arrange a consultation with me here at Circle? We can talk through your symptoms and I will examine your shoulder to determine the cause of your pain. If any treatments are indicated, I will talk through them with you so that you have all the information you need to make an informed choice. At Circle, you can see me without the need to join a waiting list, meaning we can get you treated and out of pain as quickly as possible. Rotator cuff tear can be incredibly painful, but effective treatments are available.

Philip Drew

I’ve played a lot of amateur cricket. Over the last 15 years or so, every time I’ve thrown a cricket ball, I have had a pain in my shoulder. I didn’t really think much about it, because I was still able to play. I live on an equestrian facility and am very active. One day, when I was lifting some hay bales, I felt my shoulder tear a bit.

After seeing my GP, I was referred to Harry through BUPA. After talking with Harry about the treatment options, I chose to have a course of cortisone injections. These did help a bit with the pain, but not as much as I’d hoped.

A while later, I injured my shoulder again while playing golf. That was on a Thursday, and I was able to get an appointment to see Harry the following Monday. It was so quick. After talking about things, we decided then that surgery would be needed to truly fix the problem.

The operation itself was fine, and my pain was managed well with ibuprofen. In terms of my recovery, I can’t pretend that is was a comfortable experience- it was painful! However, that’s the nature of the recovery and nothing to do with Harry. I had my physiotherapy at Circle, which I was really happy with. I actually had a physiotherapist I’d seen previously, so that was nice.

With physio and rest, I found that I was able to get back to playing golf after around 13 weeks, which was good. I did have one flare-up, which was probably me being overactive, but an additional physio session at Circle helped sort that out.

Today, I have a slight limitation on some movements. I can't get my arm up as high as the other arm, and I have some restrictions with my golf swing. I don’t need to take any pain relief, but if I've played 18 holes of golf, I do feel it afterwards, a bit like a dull ache. It’s not bad enough to stop me playing though!

From my very first meeting with Harry, we've had some really good, honest, open conversations throughout. He is a great guy and really knows what he’s doing. When we first met, he said, "Look, you've got three options really; we do nothing, we try cortisone, or we do an operation. If we do an operation, you really won't be doing much for six months, so let's see how things go with the cortisone injections."

In fact, I think I had two cortisone injections over a period of time. They definitely helped ease the pain, but after about six months they wore off and the pain was as bad as it had been originally.

I have no regrets at all about having the surgery, and can highly recommend Harry.

Fast track your treatment with Harry Brownlow

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Fast track your treatment

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020 3613 6779

Circle Reading Hospital, 100 Drake Way, Reading, RG2 0NE

Good

Overall rating 24th October 2019