If shoulder pain is making it hard to sleep, lift, or do the work and activities you love in Omaha, Elkhorn, Bennington, Gretna, or Council Bluffs, a rotator cuff tear may be the reason. These injuries are common in athletes and active adults, but they also affect people who do repetitive overhead work or simply experience natural wear-and-tear with age. The good news: most patients improve with a clear diagnosis and a focused treatment plan. As a fellowship-trained shoulder surgeon serving Omaha and Western Iowa, my goal is to help you understand your options—and get you back to the life you want.
What Is the Rotator Cuff?
Your rotator cuff is a group of four muscles and their tendons (supraspinatus, infraspinatus, subscapularis, teres minor) that stabilize the shoulder and power lifting and rotation. When one of these tendons is inflamed or torn, it can cause pain, weakness, and loss of motion. Tears range from partial-thickness (fraying) to full-thickness (a complete defect through the tendon). Early, accurate diagnosis helps match the right treatment to the right tear.
Common Causes and Risk Factors
- Overuse and repetitive overhead activity: Painting, stocking shelves, construction, mechanics, and some healthcare roles.
- Sports injuries: Baseball/softball, tennis, swimming, CrossFit, and weightlifting.
- Age-related degeneration: Tendon quality changes over time; tears become more common after age 40–50.
- Trauma: A fall on an outstretched arm, a sudden lift, or a shoulder dislocation can cause an acute tear.
- Anatomy and biomechanics: Bone spurs or poor shoulder mechanics can contribute to tendon irritation.
Rotator Cuff Tear Symptoms
- Pain on the outside of the shoulder that may radiate down the arm
- Night pain, especially when lying on the affected side
- Weakness lifting the arm, reaching overhead, or rotating the arm
- Clicking, catching, or popping with movement
- Decreased range of motion and endurance, making daily tasks harder
If these symptoms persist beyond a couple of weeks—or if they follow a clear injury—it’s smart to get evaluated by a shoulder specialist in Omaha.
When to See a Shoulder Specialist (Red Flags)
- Sudden, traumatic injury with immediate weakness
- Inability to lift the arm above shoulder level
- Pain that disrupts sleep for more than 2–3 weeks
- Loss of strength despite rest and over-the-counter meds
- You’re an athlete or have a job that requires overhead use and you need a timely return to activity
Prompt evaluation can prevent a small, repairable tear from enlarging or becoming harder to treat.
How Rotator Cuff Tears Are Diagnosed
- History and Physical Exam: I assess your pain pattern, strength, range of motion, and provocative tests tailored to each tendon.
Imaging:
- X-rays rule out arthritis or bone spurs.
- Ultrasound can quickly confirm tendon integrity in clinic.
- MRI (often the gold standard) shows tear size, retraction, muscle quality, and associated issues like biceps or labral pathology.
- Functional Goals: Understanding your work, sport, and timelines helps shape a treatment plan that fits your life.
Non-Surgical Treatment Options (Often the First Step)
Many partial tears and some full-thickness tears—especially in lower-demand patients—respond well to conservative care:
- Activity modification: Short-term reduction in overhead lifting and painful motions.
- Targeted physical therapy: Strengthens the rotator cuff and scapular stabilizers, improves mobility, and corrects mechanics.
- Anti-inflammatory strategies: Ice, topical NSAIDs, and short courses of oral NSAIDs if appropriate.
- Corticosteroid injection: Can reduce inflammation and improve pain to allow better progress in therapy (used thoughtfully to protect tendon health).
- Home program: Consistency matters; small daily wins compound into big functional gains.
With a consistent plan, many patients see meaningful improvement within 6–12 weeks.
When Surgery Is Recommended
- Surgery is considered when:
- There’s a traumatic full-thickness tear with acute weakness
- Persistent pain/weakness after a focused course of therapy (usually 6–12 weeks)
- Progressive tear size or tendon retraction on imaging
- High-demand patients (athletes or overhead workers) need durable strength and endurance
- Associated problems—like biceps tendon pathology or impingement—warrant repair or stabilization
The goal is not just to “fix the MRI,” but to restore function, relieve pain, and protect long-term shoulder health.
Arthroscopic Rotator Cuff Repair in Omaha: What to Expect
Modern repairs are typically performed arthroscopically through small incisions using a camera and specialized instruments:
- Comprehensive evaluation: I assess the entire shoulder—cuff tendons, biceps, labrum, and joint surfaces.
- Tendon repair: Anchors and sutures reattach the tendon to its footprint on bone.
- Adjunct procedures: Address bone spurs, inflamed bursa, or biceps issues if needed.
- Outpatient surgery: Most patients go home the same day with a comfortable shoulder support.
Arthroscopy minimizes soft-tissue trauma, often leading to less pain and a smoother rehab compared with older open techniques.
Recovery Timeline and Rehabilitation
Recovery is a team sport—you, your therapist, and your surgeon working toward the same goal. Timelines vary by tear size and tissue quality, but a typical plan looks like this:
- Weeks 0–2: Protect the repair; sling most of the day with brief guided motion. Emphasis on pain control, sleep comfort, and safe daily activities.
- Weeks 2–6: Gradual active assist and passive range of motion under therapist guidance; avoid active lifting with the repaired cuff.
- Weeks 6–12: Transition to full active motion and light strengthening; functional tasks expand as comfort and control improve.
- Months 3–6: Progressive strengthening; return to most daily activities and non-contact sports.
- Months 6–9+: Advanced sport/work conditioning; most athletes and heavy laborers complete return-to-play or return-to-duty testing by this phase.
Throughout rehab, we personalize milestones to your goals—whether that’s overhead sport, manual work, or simply pain-free sleep and family life.
Pain Management and Sleep Tips
- Use the sling as directed and support the arm with pillows.
- Ice regularly in the first 2–3 weeks.
- Short, multimodal pain regimens (e.g., acetaminophen, NSAIDs if appropriate, and limited prescription medication) help keep you comfortable without heavy reliance on narcotics.
- Gentle breathing and posture work reduce neck and upper-back tension that can aggravate shoulder pain.
Risks and How We Reduce Them
Every procedure carries risk, but careful planning and modern techniques help minimize complications:
- Stiffness: Prevented by guided motion and early therapy.
- Repair failure: Reduced by matching the right technique to tear type and emphasizing tendon quality, anchor configuration, and rehab pacing.
- Infection or nerve irritation: Uncommon; protocols and positioning are designed to keep you safe.
- Blood clots: Rare in shoulder surgery; individualized prevention plans are used for higher-risk patients.
We review your medical history—diabetes, nicotine use, prior surgeries—to optimize healing before we operate.
Returning to Work and Sports in Nebraska & Iowa
- Desk/remote work: Often within 1–2 weeks (in a sling), depending on comfort.
- Light duty/non-overhead roles: 4–8 weeks.
- Manual labor and overhead trades: Typically 4–6 months, sometimes longer for heavy or repetitive tasks.
- Recreational sports: Cycling and walking early; golf chipping/putting around 8–12 weeks; full swings and overhead sports often closer to 4–6 months after clearance.
Your exact timeline will reflect your tear size, tissue quality, and the demands of your job or sport.
Can Rotator Cuff Tears Be Prevented?
Not all tears are preventable, but you can lower risk:
- Balanced shoulder and scapular strength (rotator cuff + mid-back/postural muscles)
- Smart programming for overhead lifting and throwing
- Mobility and posture work to keep the shoulder centered and free
- Early evaluation when pain or night symptoms show up—small issues are easier to solve than big ones
Why Patients Choose Dr. Michael Del Core for Shoulder Care in Omaha
- Fellowship-trained shoulder surgeon specializing in arthroscopic repair, shoulder instability, and shoulder replacement
- High-volume experience with modern techniques and outcomes-focused rehab protocols
- Patient-first communication (clear plans, direct answers, and accessible follow-up)
- Convenient care for Omaha, Elkhorn, Gretna, Bennington, Waterloo, and Council Bluffs
- Team approach with trusted physical therapists to personalize your recovery
My mission is simple: get you out of pain and back to what matters—work, sport, family, and sleep.
FAQs
Do all rotator cuff tears need surgery?
No. Many partial tears and some full-thickness tears do well with therapy, activity changes, and targeted injections. Surgery is considered for persistent pain/weakness, traumatic tears, high-demand goals, or progressive imaging.
How do I know if my tear is “large” or needs urgent attention?
Traumatic tears with sudden weakness, difficulty lifting, or imaging that shows retraction typically warrant earlier surgical discussion.
How painful is recovery?
Most patients describe the first 1–2 weeks as the toughest, then steady improvement. Multimodal pain plans, ice, sling support, and good sleep positioning help a lot.
Will I be in a sling? For how long?
Yes—typically 2–6 weeks depending on tear size and repair details.
When can I drive?
Usually when you’re off prescription pain medication, can safely control the vehicle, and your arm position doesn’t compromise the repair—often after the early protection phase. We’ll discuss your situation specifically.
Can a tear come back?
It can, especially with large tears or high-demand use. Smart rehab, strength balance, and gradual return reduce risk.
Ready to Fix Your Shoulder Pain?
If shoulder pain is limiting your life in Omaha or Western Iowa, let’s create a plan that fits your goals and timeline. Whether you’re a weekend golfer in Elkhorn, a contractor in Gretna, an athlete at Creighton, or a parent who just wants a good night’s sleep, you don’t have to live with shoulder pain.
Schedule an appointment with Dr. Michael Del Core (MD West ONE) — Omaha’s shoulder specialist. 402-390-4111
Serving Omaha, Elkhorn, Bennington, Gretna, Waterloo, and Council Bluffs.
