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A little fall can lead to rotator cuff injuryNew Ulm native John Fritsche worked at Kraft for 25 years before retiring. He did a lot of heavy lifting in his position as a grade 6 cook during those years. But, he likes to joke that he used to go to work to relax. He has also been heavily involved in the New Ulm Battery for 40 years – a hobby that may seem more like an occupation that includes heavy lifting, working with horses, rifle shooting and lots of travel. A few years ago, Fritsche fell four feet off scaffolding while shingling at his mother’s house. “I didn’t fall that far, but I guess it doesn’t take much,” Fritsche said. He had torn his rotator cuff and eventually couldn’t raise his right arm above his waist. According to orthopedic surgeon Jean Eelma, MD, Fritsche’s case is a classic example of a person who would be prone to a rotator cuff injury: a person who has done heavy lifting all their life and then suffered a fall. “Rotator cuff injuries are always the result of some kind of injury: overuse, a fall, a sudden jerking motion,” Eelma said. “Something precipitates it. Throwing athletes, like those who play baseball, tennis, football, are very prone because of the motion. So are people who do overhead work much of the time.” The rotator cuff is a group of four muscles that come off the scapula (or wing bone) and join together to form one ligament or cuff that then attaches to the arm bone. Its purpose is to help stabilize the shoulder, keep the ball in the socket and to make the shoulder stronger. “Initially a rotator cuff injury is painful, but a minor partial tear may get better by itself in a couple weeks. The body will form a bridge of gristle over the tear,” Eelma said. The danger comes when it does not get better and the patient unconsciously stops using the shoulder. “Then you just don’t notice that it hurts anymore – that can lead to other injuries or tearing the rotator cuff.” Eelma said you should seek medical attention when you have limited movement of your arm or if you have continued pain or weakness. Not treating the injury increases the possibility of further harm and the muscle may actually retract from the bone, becoming virtually impossible to repair, Eelma said. Once the cuff is no longer there, the ball does not stay in proper position and that can lead to arthritis in the joint. “One common misconception is that all rotator cuff injuries require surgery,” Eelma said. “The flip side is the misconception that all rotator cuff injuries will heal themselves if you just protect them – I see both extremes.” Although the vast majority of rotator cuff injuries are due to partial tears and can heal with physical therapy, anti-inflammatory medications, and sometimes cortisone injections, there is a minority of people who actually require surgery. There are three kinds of surgery for rotator cuff repair, Eelma said: open surgery, a mini-open surgery or arthroscopic surgery. Open surgery, she said, is still the “gold standard,” even though advancements have been made in the area of arthroscopic procedures in the last several years. No matter which type of surgery is performed, recovery is about the same for all of them, Eelma said. “Going in arthroscopically does not mean a quicker rehabilitation.” The patient can generally return home the same day of the surgery, but some patients may require an overnight stay. If the injury involved a partial tear or bone spur and tendonitis, the patient will usually need to wear an arm sling for three or four days and will generally return to normal activity in two weeks. If the cuff has to be repaired, there is a six week time period before a return to normal activity. It took Fritsche a little longer to return to normal activity, mostly because he didn’t have the surgery done until about three months after the injury. Fritsche says he delayed the surgery because he couldn’t take the time. His work with the Battery was keeping him too busy. When he finally did have the surgery done, he couldn’t have been happier with the outcome. “I would recommend this surgery to anyone. It took me six months or so to get back to where I was completely happy with the use of my arm, but it was worth it.” Fritsche laughed, “Now, when I grab that horse’s bit with my right hand, I can make him understand me.”  Back to Health Edition |
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New Ulm Medical Center
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