Rotator Cuff Surgery
Brian Butzen MD, Board-Certified Fellowship-Trained Orthopedic Surgeon Specializing in Shoulder, Wrist, and Hand Surgery
As Dr. Brian Butzen, a board-certified, fellowship-trained orthopedic surgeon specializing in shoulder, wrist, and hand surgery, I've been serving the Four Corners community since 2013. My extensive experience performing rotator cuff surgeries, combined with my fellowship training in upper extremity surgery, has helped hundreds of patients like Sarah return to their active lifestyles. Patients consistently express their satisfaction with both their surgical outcomes and the personalized care they receive throughout their recovery journey. My commitment to this region means I understand the unique needs of people in Durango, Farmington, Cortez, and Pagosa Springs - whether you're dealing with a work injury, sports-related tear, or age-related shoulder problems.
Last month, I met Sarah, a 52-year-old teacher from Pagosa Springs who had been dealing with shoulder pain for over a year. She couldn't lift her arm to write on the whiteboard without sharp pain shooting through her shoulder. After months of physical therapy and steroid injections, she finally learned she had a full-thickness rotator cuff tear that needed surgery. Six months after her rotator cuff surgery with me, Sarah returned to her classroom pain-free and couldn't stop thanking me for giving her back her ability to teach effectively.
Sarah's story is one I hear often in my practice here in Durango. The rotator cuff - those four small muscles that keep your shoulder stable - can tear from overuse, injury, or simple wear and tear over time. When conservative treatments don't work, rotator cuff surgery becomes the path back to pain-free movement.
What Is a Rotator Cuff Tear?
Your rotator cuff is like the guy-wires on a tent. These four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) work together to keep your shoulder ball centered in its socket. When one or more of these muscles tears, your shoulder loses stability and strength.
In my years practicing as a Durango orthopedic surgeon, I've seen rotator cuff tears happen in many ways:
Sudden injuries from falls or accidents
Gradual wear from repetitive overhead activities
Age-related degeneration of the tendons
Previous shoulder injuries that didn't heal properly
The Four Corners region keeps me busy with rotator cuff injuries. Our outdoor lifestyle means people are constantly using their shoulders - whether they're mountain biking in Cortez, skiing at Purgatory, or working on ranches around Farmington. All these activities can stress the rotator cuff over time.
Signs You Might Need Rotator Cuff Surgery
Not every rotator cuff tear needs surgery. Many partial tears heal with physical therapy and rest. However, certain signs point to surgical repair being your best option:
Pain that won't go away - If you've tried physical therapy, anti-inflammatory medications, and steroid injections for several months without improvement, surgery might be needed.
Weakness in your arm - When you can't lift your arm above shoulder height or struggle with simple tasks like reaching into a cabinet, the tear may be too large to heal on its own.
Night pain - Rotator cuff tears often hurt most at night. If you're losing sleep because of shoulder pain, surgery can help restore your rest.
Loss of function - When daily activities become difficult or impossible, surgery can restore your ability to use your arm normally.
Types of Rotator Cuff Surgery
Modern rotator cuff surgery has come a long way. As a fellowship-trained orthopedic surgeon, I use the most advanced techniques to repair these tears with minimal invasion to your body.
Arthroscopic Rotator Cuff Repair
Most rotator cuff surgeries today are done arthroscopically. This means I make small incisions (about the size of a pencil eraser) and use a tiny camera to see inside your shoulder. The benefits include:
Less pain after surgery
Smaller scars
Faster recovery
Lower infection risk
During the procedure, I clean up any damaged tissue and reattach the torn tendon to the bone using special anchors. These anchors are made of materials that either dissolve over time or stay permanently without causing problems.
Open Rotator Cuff Repair
For very large tears or complex cases, open surgery might be needed. This involves a larger incision but allows me to see and repair the damage directly. While recovery takes longer, this approach is sometimes necessary for the best long-term results.
Partial Rotator Cuff Repair
Sometimes only part of the rotator cuff is torn. In these cases, I can often repair just the damaged portion while preserving healthy tissue. This leads to faster healing and better outcomes.
What to Expect Before Rotator Cuff Surgery
Before scheduling your surgery, we'll make sure you're a good candidate. This includes:
Detailed examination - I'll test your shoulder strength, range of motion, and pain levels to understand exactly what's wrong.
Imaging studies - MRI scans show me the size and location of your tear, helping me plan the best surgical approach.
Medical clearance - We'll review your overall health to ensure you're ready for surgery and anesthesia.
Setting realistic expectations - Recovery from rotator cuff surgery takes time. Most people see significant improvement, but it's a gradual process that requires patience and commitment to rehabilitation.
The Surgery Day Experience
On surgery day, most patients arrive at our surgical center in Durango early in the morning. The procedure typically takes 1-3 hours, depending on the complexity of your tear.
You'll receive general anesthesia, so you'll be completely asleep during the surgery. I also use nerve blocks to help control pain after the procedure. This means you'll wake up with minimal discomfort.
After surgery, you'll spend time in recovery before going home the same day. Most patients don't need to stay overnight in the hospital.
Recovery After Rotator Cuff Surgery
Recovery happens in phases, and each person heals at their own pace. Here's what most patients experience:
First 6 Weeks: Protection Phase
Your arm will be in a sling to protect the repair. During this time:
Keep the sling on at all times except when showering
Do gentle finger and wrist exercises to prevent stiffness
Avoid lifting anything heavier than a coffee cup
Sleep in a recliner or propped up in bed
6-12 Weeks: Early Motion Phase
We'll start gentle shoulder movements with physical therapy:
Gradual range of motion exercises
Passive stretching (therapist moves your arm)
Light activities of daily living
Continued protection from heavy lifting
3-6 Months: Strengthening Phase
Your shoulder will get stronger during this phase:
Active range of motion exercises
Progressive strengthening with resistance bands
Return to light recreational activities
Gradual return to work activities
6-12 Months: Return to Full Activity
Most patients reach their maximum improvement by one year:
Full strength and motion
Return to sports and heavy activities
Minimal or no pain
Satisfaction with the surgery results
Success Rates and Long-term Outcomes
Rotator cuff surgery has excellent success rates when done properly. In my practice, over 90% of patients report significant improvement in pain and function. Most people return to their desired activities within 6-12 months.
However, success depends on several factors:
Size of the original tear
Quality of the remaining tendon
Patient age and overall health
Commitment to rehabilitation
Following post-operative instructions
Common Concerns About Rotator Cuff Surgery
"Will I need another surgery?" - Re-tear rates are low when the repair is done properly and patients follow recovery guidelines. Most repairs last for life.
"How much pain will I have?" - Modern pain management techniques make recovery much more comfortable than in the past. Most patients describe the pain as manageable with medication.
"When can I drive again?" - You can usually drive when you're out of the sling and have good control of your arm, typically 6-8 weeks after surgery.
"Will I be able to throw a baseball again?" - Return to overhead sports depends on your specific situation. Many patients return to their previous activity level, but this varies by individual.
Why Choose Dr. Brian Butzen for Your Rotator Cuff Surgery
Since 2013, I've been helping patients in the Four Corners region recover from shoulder injuries. As part of Animas Orthopedic Associates, I focus specifically on shoulder, wrist, and hand problems. My fellowship training in upper extremity surgery means I've received specialized education beyond general orthopedic surgery.
I understand the active lifestyle of people in Durango, Farmington, Cortez, and Pagosa Springs. Whether you're a weekend warrior or someone who needs their shoulder for work, I'll create a treatment plan that fits your life and goals.
My patients appreciate my straightforward approach. I'll tell you honestly whether surgery is right for you or if other treatments might work better. When surgery is the best option, I'll explain exactly what to expect and support you through every step of recovery.
Taking the Next Step
If you're dealing with shoulder pain that's affecting your daily life, don't wait for it to get worse. Rotator cuff tears don't heal on their own, and delaying treatment can make surgery more complex and recovery longer.
I see patients at my main office in Durango and also have a satellite clinic in Pagosa Springs for the convenience of patients in that area. Whether you're coming from Farmington, Cortez, or anywhere in the Four Corners region, I'm here to help you get back to the activities you love.
The first step is a thorough evaluation to understand what's causing your shoulder pain. Together, we'll create a treatment plan that gets you back to living without limitations. Remember, rotator cuff surgery isn't just about fixing a tear - it's about restoring your quality of life.
Your shoulder pain doesn't have to be permanent. With the right treatment approach and commitment to recovery, most patients return to full, pain-free function. If you're ready to take the next step toward healing, I'm here to guide you through the process with the expertise and personal attention you deserve.