In the case of a post-traumatic rupture in a young person, the indication for surgical repair is no longer in doubt. Only surgical repair can restore full strength to the shoulder.
In the case of a lesion arising from wear-and-tear tendinopathy, conservative treatment can be attempted with physiotherapy sessions combined with infiltrations. This treatment will not heal the tendon, but it will relieve the patient.
Even in the elderly, repair should be attempted to improve shoulder functionality.
Initially, the shoulder will be immobilized with a sling or shoulder splint to allow the repaired tendon to heal. This splint must be maintained for four weeks.
Physiotherapy sessions start the day after surgery, and initially we recommend only passive mobilization. It is suggested not to remove the splint for the first four weeks, except when washing, when the arm must be maintained.
Only after four to six weeks, when tendon healing is well advanced, can we begin active mobilization and muscle-strengthening exercises. After three months, the patient should be able to lift around two kilos over the head. Muscle-strengthening exercises should be continued until full recovery, which usually occurs around six months after surgery, when the patient has regained 80% of his or her former strength.
The hematoma - It quickly disappears.
Shoulder stiffness or pain - This ceases gradually after well-controlled physiotherapy sessions (after coiffe repair, 60 to 90 physiotherapy sessions are required).
Incisional infection - This is a very rare complication.
Algodystrophy - Rare complication.
The patient is seen in consultation. Several tests are performed during the clinical examination to identify the injured tendon.
To confirm the diagnosis, the surgeon will order a radiological work-up: ultrasound, arthroscanner or NMR.
In the case of a sudden, severe rupture, the patient is unable to lift his arm. He can barely lift it a few degrees from his body (pseudo-paralytic shoulder). The pain is considerable. If the rupture is less severe, certain movements are still possible, but always with pain. When the rupture is incomplete and progressive, the pain is better tolerated. The patient realizes that his or her range of motion is progressively reduced.
The rotator cuff is the union of four tendons that attach to the head of the humerus. The muscles of these tendons ensure the stability of the joint and move the arm in different directions. These muscles and their tendons provide the connection between the scapula and the humerus.
Rupture of these tendons occurs in the event of a fall, wrong movement or dislocation of the shoulder. The tendon may also rupture spontaneously, through wear and tear.