fatty infiltration

 You may hear the term “fatty infiltration” for the first time when you see a physician about a rotator cuff injury. After you tear the tendon in your shoulder, a large gap remains between the tendon and the bones, keeping the shoulder muscle from performing its usual actions of shortening and lengthening. The body attempts to heal itself by “filling” the gap, unfortunately, with fatty tissue rather than muscle—and it remains there permanently. When muscle is replaced with fat, the result is reduced function and discomfort.

Surgery cannot fix the problem, but it may prevent the infiltration from progressing further. Studies have shown that the more fatty infiltrate, the higher the risk of suboptimal healing after rotator cuff surgery. Your surgeon may examine the amount of fatty infiltrate in your shoulder using a computed tomography scan and assess the damage by measuring the percentage of muscle the fatty tissue has invaded.

Although recent research has offered some hope that certain drugs might reduce fatty infiltration after rotator cuff tears, at the moment there is not much that can be done to stop this process from happening. Postsurgery, a good physical therapy rehabilitation program can enhance the results of your procedure, regardless of the degree of fatty infiltration. An individualized program of physical therapy can help to:

  • relieve pain and swelling 
  • prevent pain and injury recurrence 
  • develop a progressive strength-training routine 
  • teach techniques you can perform at home 

The sooner physical therapy is started after a cuff repair, the better. That way, we can counteract the negative impact of the fatty infiltration by strengthening surrounding muscles and helping the shoulder heal more quickly and effectively.

Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, and Bergen County region.  This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.

When rotator cuff surgery is needed, the surgeon has to take into consideration whether or not fatty infiltration has occurred. Ideally, the surgeon can perform the surgery at an early enough stage—before fatty infiltration becomes an issue.

What is fatty infiltration? Sometimes, when the rotator cuff tendons have significantly pulled away from the bone where they have been attached, fat infiltrates the muscular portions, resulting in weakened muscles. Although the surgeon will take this into account when performing a repair, weakness can remain even after the rotator cuff has been repaired.

Fortunately, with successful surgery, the process of fatty infiltration does not generally progress any further. While the previous changes are irreversible, the addition of physical therapy can be critical to rebuild strength in the muscles. Since there is also no clear understanding of how fatty infiltration prior to surgery may affect the healing and surgical outcomes, it is even more important to start physical therapy soon after surgery.

We can help in a number of ways that go beyond just improving movement after you have experienced fatty infiltration. Your individualized physical therapy program can help to

  • relieve pain and swelling
  • teach techniques you can perform at home
  • prevent pain and injury recurrence
  • develop a progressive strength-training routine

Through personal attention and collaboration, we can provide you with numerous exercises after rotator cuff surgery. Together, we can devise a long-term plan to provide positive postsurgical results. When physical therapy is included after fatty infiltration and rotator cuff repair, long-term outcomes are more likely to be optimistic.