What to know about rotator cuff injuries as RFK Jr. undergoes shoulder surgery
Health Secretary Robert F. Kennedy Jr. had surgery Tuesday for an injured rotator cuff. The 72-year-old is expected to return to work Monday, according to a Department of Health and Human Services spokesperson, although doctors say recovery may be slow and painful.
The key to optimal recovery is a gradual return to activity, including wearing a harness after surgery and physiotherapy.
The rotator cuff, a group of muscles and tendons that surround the shoulder joint, is used for a variety of movements such as raising the arm, said Dr. Gus Mazzocca, medical director of Mass General Brigham Sports Medicine. This includes activities like brushing your hair, searching for items on shelves, or playing certain sports.
The rotator cuff is made up of four muscles and tendons, said Dr. Laith Jazrawi, chief of sports medicine at NYU Langone Health, including the supraspinatus, infraspinatus, teres minor and subscapularis.
Symptoms of an injury may start with arm weakness or a dull shoulder ache and lead to pain when you raise your arm above your head, Jazrawi said.
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Although rotator cuff injuries can occur in young athletes, they are more common in older adults due to age-related changes, Mazzocca said.
“Typically, when you take an MRI on someone over 60, they have some degree of rotator cuff pathology,” Jazrawi said.
A Finnish study published last month in JAMA Network Open found that 99 percent of the population over 40 had at least one detectable problem with their rotator cuff on an MRI, whether or not they had symptoms.
Rotator cuff injuries can be complicated and the symptoms don’t always match the extent of the damage, Mazzocca said.
“You can have a very small tear that’s very symptomatic and we repair it, or you can have a massive tear that’s actually not symptomatic and you don’t need to repair it, and then anywhere in between,” he said.
It is unclear when Kennedy injured his shoulder. As part of its “Get Active and Eat Real Food” campaign, it released a workout video with musician Kid Rock on Feb. 17, featuring the shirtless Health Secretary doing push-ups and bicep curls and riding a stationary bike.
Rotator cuff damage, like many sports injuries, is treated with either non-surgical or surgical options, Jazrawi said.
Non-surgical options may include rest, ice, anti-inflammatory medications like ibuprofen, steroid injections, or physical therapy.
Experimental treatments such as BPC-157, an injectable peptide, have been used by bodybuilders for recovery and are gaining popularity among other athletes.
Unfortunately, the data hasn’t yet lived up to the hype, Jazrawi added, saying larger studies are needed. The peptide is not approved
Surgery is usually reserved for severe tears or tears that do not respond to conservative measures. Jazrawi said older people with degenerative changes might be more likely to be treated conservatively, while younger patients who suffer a tear from a sports injury might be more likely to need a procedure to return to an active lifestyle.
Rotator cuff repairs are usually performed arthroscopically, a minimally invasive surgery that involves using a camera and small instruments through tiny incisions to repair problems in the shoulder joint. This generally results in less pain and a faster recovery than an open, more invasive procedure.
Recovery after the procedure can be difficult, Mazzocca said, because patients often complain of pain during the process. One method doctors use to help patients is to inject an anesthetic into the nerves that control pain, a procedure called a nerve block.
Over the next few months, patients can then gradually begin to intensify their activity to regain their strength.
“Typically it lasts four to six weeks in a sling,” Jazrawi said. “I usually tell patients four to six months recovery or return to lifting in about six months.”
