WASHINGTON — Democratic presidential candidate John Kerry may be waving to supporters instead of shaking hands for a few weeks after outpatient surgery Wednesday to repair a minor shoulder injury.

Kerry tore part of his rotator cuff in January, when he wrenched his right shoulder while bracing himself during an abrupt stop on his campaign bus.

It seemed to be a minor tear of the subscapularis tendon, one of the tendons that make up the rotator cuff, so his physician initially advised seeing if it would heal on its own.

The Massachusetts senator felt well enough for a recent skiing and snowboarding vacation. But he reports pain after certain movements and so chose to have the tendon surgically repaired, said Dr. Bertram Zarins, chief of sports medicine at Massachusetts General Hospital, who will perform the operation.

"Unless he repairs the tear now, it will further atrophy or weaken and cause more problems in the future," Dr. Bertram Zarins, who will perform the operation, told reporters Monday. "To repair it now is relatively easy compared to doing it later," he added, saying he expected "a full recovery."

Also Monday, Kerry's campaign released a letter from the candidate's primary physician declaring that overall, "he is in excellent health."

The operation requires general anesthesia and should take about 45 minutes. Zarins will operate through a 1 1/2- to 2-inch incision in the front of the shoulder. Kerry will go home Wednesday afternoon, with narcotic painkillers for two to three days as needed. He'll wear a sling for a day or two before being allowed "to use the arm carefully," Zarins said.

"Within two or three weeks, he'll be shaking hands," the doctor said, although raising his arm overhead will be difficult for a few more weeks.

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Rotator-cuff tears are very common: "We do this type of surgery every day," Zarins noted. But the subscapularis is a less common spot, and he acknowledged that he won't know the extent of the tear until Wednesday.

Kerry originally injured his right shoulder in 1992 after a fall from his bicycle. This is a new injury, Zarins said, although the earlier accident might have "changed the mechanics" of the shoulder a bit to make it more vulnerable.

Kerry interrupted his campaign schedule for surgery twice last year. He had a cancerous prostate removed in February 2003 and minor outpatient surgery to remove a wart on his eyelid the following month.

Follow-up medical exams indicate the prostate surgery was successful, Kerry's regular physician, Dr. Gerald Doyle, said Monday. Normal blood pressure and low cholesterol suggest Kerry has "a lower than average risk" for heart disease for a man his age, Doyle wrote. Kerry is 60.

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