rotator cuff specialist Perth

Rotator cuff specialist Perth

Everything you need to know about rotator cuff tears

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Rotator cuff tear Perth

Could my shoulder pain be caused by a rotator cuff tear or injury?

Your rotator cuff is a group of four muscles and tendons that are on your scapula (shoulder blade) and attach to the humerus (upper arm bone). These muscles and tendons help to lift and rotate your arm. When the rotator cuff muscles and tendons are healthy and functioning properly, they allow you to lift, rotate, and move your arm in various directions. 

If you have shoulder pain, it is possible that there is an issue with these four muscles and tendons.

Rotator cuff injuries are more common in middle-aged and older individuals. As you age, the tendons and muscles in the rotator cuff tend to become weaker and more prone to injury. They are also more susceptible to wear and tear over time due to the heavy demands placed on them, which can lead to degeneration and injury.

Dr Sven Goebel | Shoulder Surgeon Perth

rotator cuff specialist Perth

If you have been doing the same physical activity over and over again, you are more prone to rotator cuff injuries too.

In some cases, tears can form on the tendons, creating more pain and discomfort. 

The most common symptoms of a rotator cuff tear are pain and weakness in the shoulder. The pain may be worse when you lift your arm or when you sleep on the affected side. You may also have difficulty lifting and rotating your arm, and you may feel a sensation of grinding or catching when you move your shoulder. Often the pain is worse during the night.

Other symptoms of a rotator cuff tear may include

  • Swelling and tenderness in the shoulder
  • A decrease in range of motion in the shoulder
  • A sensation of instability or “giving way” in the shoulder
  • A crackling or grinding sound when you move your shoulder

It is important to identify the specific cause of your shoulder pain in order to determine the best treatment option. But before we explain surgical and non-surgical treatment, let’s explain the two types of rotator cuff tears.

Atraumatic rotator cuff tear

An atraumatic rotator cuff tear is a tear that occurs gradually over time, usually due to wear and tear on the shoulder muscles and tendons. These types of tears are often seen in people who do a lot of overhead activity or work. 

Atraumatic rotator cuff tears may not always require surgery and can be treated with physical therapy and other non-surgical treatments. The younger the patient the more likely it is to require surgery.

Traumatic rotator cuff tear

A traumatic rotator cuff tear is a tear that occurs as a result of a sudden injury, such as a fall or a direct blow to the shoulder. These types of tears are much less common and typically more severe and more often than not require surgery to repair. It is important that surgery is not delayed as the outcome is poor when these tears are left for longer than a few weeks. 

Rotator cuff specialist Perth

How are rotator cuff tears diagnosed?

If you are experiencing symptoms of a rotator cuff tear, such as pain, weakness, or a decrease in range of motion in your shoulder, it is important to see a rotator cuff surgeon for a proper evaluation.
Typically I will look at your medical history and imaging tests, and I’ll do a physical examination. We will discuss your symptoms and I will examine your shoulder for signs of a rotator cuff tear.

Dr Sven Goebel | Shoulder Surgeon Perth

For example, I will test your range of motion and strength in your shoulder and may ask you to perform certain movements to assess the function of your rotator cuff. 

Imaging tests, such as x-rays, magnetic resonance imaging (MRI), or ultrasound, can be used to visualise the rotator cuff and determine the extent and location of the tear.

X-rays can help to rule out other conditions, such as a shoulder fracture, but are not very effective at showing soft tissues like muscles and tendons. MRI scans are the preferred and most reliable test to look for soft tissue injuries and abnormalities and can be used to confirm a diagnosis of a rotator cuff tear.

Rotator cuff repair Perth

Surgery for rotator cuff tears?

People often ask me what the recommended first-line treatment is for rotator cuff tears. The answer is: treatment depends on four things.

  • The specific characteristics of the tear,
  • Your age,
  • Your activity level,
  • Your symptoms.

Treatment may include a combination of non-surgical and surgical options.

Non-surgical treatment options for a rotator cuff tear

  • Physical therapy: can help improve your range of motion, strength, and function in your shoulder. Your physical therapist may recommend specific exercises to stretch and strengthen the muscles around the shoulder.
  • Medications: Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. Your doctor may also prescribe other pain medications if needed.
  • Injections: Corticosteroid injections can be used to reduce inflammation and pain in the shoulder.
  • Activity modification: Changing certain activities or avoiding activities that cause pain or discomfort may help to reduce symptoms.

If non-surgical treatment is not indicated or does not provide sufficient relief from symptoms, surgery may be recommended.

Rotator cuff repair

There are several different surgical options for repairing a rotator cuff tear, including

  • Arthroscopic rotator cuff repair
  • Arthroscopic debridement (clean-up) and subacromial decompression
  • Reverse shoulder replacement

The best treatment option will depend on the specific characteristics of the tear and your individual needs and preferences.

rotator cuff specialist Perth

Rotator cuff surgery recovery

What happens after surgery?

Before your rotator cuff surgery, during your consultation, I will explain which exercises you can do for optimal recovery.

In general, I recommend after a rotator cuff repair:

Having a shower:

1 day after surgery

Light exercise:

8-10 weeks after surgery


7-10 weeks after surgery

Normal exercise:

4-6 months after surgery

Going back to work:

2-3 weeks (sedentary job) and 5-9 months (manual job) after surgery