How did the tear in my arm occur?
The general causes of the tear in your shoulder: the loss of power in and the degeneration of your muscles with advancing age - repetitive, forceful movements due to housework or work (such as window cleaning at home, an excessive effort for cleaning, knitting, repetitive heavy lifting…)
What are the signs of the tear?
The tear in your shoulder is caused by the friction of the constricted shoulder tendon(s) and/or the abrasive effect of the inflamed tissue over time. When a tear occurs, it presents itself with symptoms such as weakness in shoulder movements, which you will also notice (e.g. dropping a glass in your hand), and particularly, pain felt at night (such as not being able to lie on the shoulder and waking up because of the pain while changing the sleeping position).
How should I lie while sleeping (After surgery)
Unfortunately, my only suggestion for this would be the determination of the position that the patient is comfortable in by himself/herself.
When will I be able to do housework?
Considering that you will use a shoulder sling for about 6 weeks and then receive physical therapy for about 6 weeks, it is recommended that you do not return to your routine, forceful daily activities for 3-4 months. However, you can easily perform your personal, light-unforceful activities (without - actively - lifting your shoulder by yourself)
When will I be able to eat on my own?
As of the first day following the surgery, you can easily eat while your shoulder is in the sling.
For how long and how should I use the ice?
Unless recommended otherwise by your doctor, applying ice on your entire shoulder for the first two days (48 hours) following surgery is a very useful practice for pain control as well as the control of swelling in your shoulder.
Ice can be applied on the area a couple of times a day for twenty minutes. It is usually recommended to take a one-hour or longer break between ice treatments
How long will I have to use the shoulder sling after surgery?
Are the small screws you implanted permanent?
The implanted screws, called anchors, are at the micro level, i.e. very small and they occupy very little space in the bone. These screws serve to reattach the torn tendon to its original location in the bone which it got torn from. Since they are very small and remain in the healed tendon, the fact that they remain in the body poses no problems. In some cases, anchors that can dissolve in the body within a period of 6-9 months can also be used based on the surgeon's decision.
What are the chances for a tear to reoccur in my shoulder? What should I do to avoid it?
The recurrence of a tear is still debated. Tears may occur again, particularly in old aged people with tissues of a poor quality and concomitant diseases such as diabetes-rheumatism; smokers, and those who suffer a severe shoulder trauma again.
Recurrent tears mostly occur within the first 4 months after surgery. Therefore, forceful movements in the first 4 months after surgery, before the shoulder is sufficiently strengthened, should strictly be avoided.
At this point, it should particularly be emphasized that smoking!, i.e. tobacco use not only delays the healing of a tear but is also a proven factor for the recurrence of one.
Will my tear heal if I don't have surgery?
If you have a tear with concomitant complaints, which is viewed on an MRI, it is not possible for the torn tendon to heal on its own. Over time, your tear will most likely grow. In addition, it has been shown by scientific studies that it would cause your other untorn tissues to also be affected adversely; your complaints to continue at an increasing rate; your weakness to increase; and furthermore, arthritis in your shoulder joint.
Another point that I would like to emphasize here is that the tears tend to rapidly expand in a period of 4-6 months, particularly in case of tears occurring as a result of trauma (falling or sudden improper movements).
When will I be able to take a shower after surgery?
Since the surgery is not open and arthroscopic, i.e. closed, the wound will be in 3-4 pieces, each of which will be 0.5-1 cm in size, so you'll be able to take a shower in the early post-operative period.
On the 5th day following surgery, patients can easily take an assisted shower with warm water using a transparent cover such as stretch film.
Should there be physical therapy after surgery? and how?
The physical therapy process after surgery is an indispensable continuation of your treatment. In other words, if physical therapy is not or cannot be performed, the success rate of your surgery dramatically decreases. Physical therapy, i.e. post-operative rehabilitation, is performed in accordance with roughly the following principles: the recovery of the range of motion and then strengthening of the shoulder. The rehabilitation stages follow one another. Patient's compliance and contribution to rehabilitation is the key to success. Strengthening begins after 3 months. Sports involving weight lifting and collision (such as football, basketball) are strictly prohibited before the 6th month. In conclusion, the post-operative rehabilitation program to be recommended by your doctor plays a key role in the success of your treatment.
What kind of anesthesia will I receive? and when will I be discharged after surgery?
You will receive general anesthesia. Your surgery is performed in a sitting position called the beach chair position. After you enter the operating room, your surgery can begin in 1 hour under the best circumstances since we anesthetize you and set your position.
After the operation, an ice treatment that will last two days while you're in bed is commenced immediately and painkillers are provided. After the closed, i.e. arthroscopic repair, most of our patients (unless there is a medical obstacle) can be sent home (they can walk out of the hospital) in the evening of the same day with a shoulder-arm sling. Your wounds are dressed every other day, i.e. every two days. Your stitches are usually removed on the 9th-10th day after surgery. Subsequently, the post-operative rehabilitation program is started on the 4th-5th week, based on your doctor's recommendations. The schedule I mentioned above is standard and can be changed by your doctor.
How long will it take for me to recover after surgery?
In general, most patients experience a noticeable improvement, particularly in terms of pain and daily activities. In other words, when asked how they feel one year after the surgery, 90% of our patients state that they benefited from the surgery to a great extent and were satisfied with it. The restoration of the previous strength of the shoulder depends on the quality of the tendon, the completion of the tendon healing and the completion of the physical therapy process as mentioned earlier.
How do I put my clothes on and off after surgery?
Clothing and Shower Care
Is surgery the only treatment for a torn tendon?
The answer to this question depends on the condition of the other shoulder muscles and the age of the patient. Most elderly patients can go on with their lives without any pain and disability even if they have rotator cuff tears, since they don't have any complaints. In a study, rotator cuff tears were identified in 40% of patients who are older than 70 years, but no associated symptoms (signs/findings) were observed. However, surgical treatment is recommended for the younger age groups and particularly, if their tears are caused by a sudden injury.
Are steroids injected for constriction harmful?
A limited number of (3-4) steroid injections that are usually made into the area in the middle quarter called the bursa are safe, and often significantly reduce the local inflammation (non-microbial inflammatory state) and pain. These locally applied steroids do not pose the same risks as chronic steroids, i.e. those taken orally on an ongoing basis, since they are not systemically absorbed in the body. However, repeated steroid injections were shown to adversely affect the quality of tendons in cases that may require surgery later on.