Rotator Cuff Arthropathy

The shoulder is a ball and socket joint and one of the most mobile joints in the body, allowing you to lift, rotate, and extend your arm in nearly every direction. Much of this movement is controlled by the rotator cuff, a group of four muscles and their tendons. These tendons keep the ball of the upper arm bone (humerus) stable in the shallow shoulder socket and help power movements. When an injury or wear-and-tear damages the rotator cuff, pain, weakness, and limited motion can develop. For many patients, minimally invasive surgery called rotator cuff arthroscopy may be recommended to allow the surgeon to view the inside of the joint to assess and treat the damage to restore function and relieve symptoms.

What is rotator cuff arthroscopy?

Rotator cuff arthroscopy is a minimally invasive surgical procedure used to examine and repair tears or damage to the rotator cuff tendons. Instead of making a large incision, Dr. Waterman makes small incisions and inserts a small camera, called an arthroscope, into the shoulder joint to view the inside of the joint to diagnose and treat damage.

The arthroscope projects images onto a TV screen, allowing the surgeon to see inside the joint in detail. If damage is identified, Dr. Waterman will use tiny specialized instruments that are inserted through additional small incisions to trim, smooth, or repair torn tissue. Because the approach requires only small incisions, recovery is often quicker and less painful compared to traditional open surgery.

This procedure may also involve cleaning out inflamed tissue (debridement), shaving bone spurs that pinch the rotator cuff, or suturing torn tendons back to the bone. In some cases, advanced techniques such as anchors and sutures are used to secure the tendon. The goal is to restore stability and function while reducing pain. This minimally invasive procedure is performed under anesthesia.

What are the symptoms of a rotator cuff tear?

Rotator cuff injuries can occur suddenly, such as from lifting a heavy object or falling on an outstretched arm, or they may develop gradually with repetitive overhead use. Common symptoms that lead people to seek medical care include:

• Shoulder pain, especially when lifting the arm or reaching overhead
• Weakness in the shoulder or difficulty holding objects
• Night pain that makes sleeping on the affected side difficult
• A crackling or popping sensation with movement
• Limited range of motion or stiffness

When symptoms persist and interfere with daily activities, evaluation by a sports medicine specialist like Dr. Brian Waterman is recommended.

What causes rotator cuff injuries?

There are several ways the rotator cuff can become damaged. Acute injuries can result from falls, sports collisions, or lifting accidents. More commonly, rotator cuff tears develop gradually over time due to repetitive use and age-related changes in the tendon tissue. Bone spurs that develop on the acromion (a part of the shoulder blade) may rub on the rotator cuff tendons, causing irritation and tears. Occupations or sports that require frequent overhead motion, such as painting, carpentry, swimming, or baseball, can increase the risk. Genetics, poor posture, and reduced blood flow to the tendons with aging can also contribute.

How is a rotator cuff injury diagnosed?

Diagnosis begins with a thorough history and physical examination. During the exam, the doctor evaluates strength, range of motion, and specific shoulder maneuvers that may reproduce symptoms. Imaging studies are often needed to confirm the diagnosis. X-rays can show bone spurs or arthritis, while MRI or ultrasound provides detailed images of the rotator cuff tendons, showing the size and location of tears. These tests help determine whether non-surgical care or arthroscopy is the most appropriate treatment.

What are the risks of the rotator cuff arthroscopy procedure?

While rotator cuff arthroscopy is considered safe and effective, as with any surgery, there are potential risks. These may include:

• Infection at the incision sites
• Stiffness or loss of motion in the shoulder
• Re-tear of the rotator cuff tendon
• Nerve or blood vessel injury (rare)
• Persistent pain despite surgery
• Complications from anesthesia

Choosing a highly experienced orthopedic surgeon reduces these risks significantly. Dr. Waterman specializes in advanced arthroscopic techniques and tailors treatment to each patient’s unique needs.

What is recovery after surgery?

Recovery from rotator cuff arthroscopy usually involves a structured rehabilitation plan. Initially, the arm may be supported in a sling to protect the repair. Gentle range of motion exercises are started early to prevent stiffness. Over time, guided physical therapy helps restore strength and mobility. Full recovery can take several months, depending on the size of the tear and individual healing. Patients who follow their rehabilitation plan closely often achieve excellent pain relief and improved function.

If you or a loved one are experiencing ongoing shoulder pain, weakness, or difficulty lifting your arm, it is important not to ignore these symptoms. Early evaluation and treatment may prevent further damage and improve your long-term outcome. Non-surgical options such as rest, physical therapy, and injections are often tried first. However, if these treatments do not provide relief, rotator cuff arthroscopy may be the best solution.

Shoulder pain can make everyday activities—from reaching into a cabinet to playing your favorite sport—challenging and frustrating. You do not have to live with constant discomfort or limited mobility. Dr. Brian Waterman, Board Certified and Fellowship Trained Orthopedic Surgeon and Sports Medicine Expert in Winston-Salem, North Carolina, offers advanced diagnostic and treatment options, including rotator cuff arthroscopy, to help restore shoulder strength and function.

If shoulder pain is affecting your quality of life, now is the time to take action. Contact Dr. Waterman’s office today to schedule a consultation and learn more about whether rotator cuff arthroscopy is right for you. With expert care and a personalized treatment plan, you can get back to the activities you love with confidence.