Rotator Cuff Tear


 

What is the rotator cuff?

The rotator cuff is a group of muscles and tendons in your shoulder. They help you lift and move your arms away from your body. The rotator cuff keeps the ball of the upper arm bone (humerus) in the shoulder blade socket.

 

What is a rotator cuff tear?

The shoulder is a ball-and-socket joint that’s part of the skeletal system. It’s like a golf ball sitting on a golf tee. Rotator cuff tears occur when tendons pull away from the arm bone. A tear may result from overuse or another injury. More than two million Americans experience some type of rotator cuff problem every year. Rotator cuff tears affect people of all ages and genders, but the problem is more common in adults.

 

What are the types of rotator cuff tears?

Types of torn rotator cuffs include:

  • Partial: With an incomplete or partial tear, the tendon still somewhat attaches to the arm bone.
  • Complete: With a full-thickness or complete tear, the tendon separates completely from the bone. There’s a hole or rip in the tendon.

 

What causes a rotator cuff tear?

An accident, such as a fall, can cause a broken collarbone or dislocated shoulder that tears the rotator cuff. More commonly, rotator cuff tears occur over time as the tendon wears down with age and use (degenerative tear). People over 40 are most at risk, though anyone can experience a rotator cuff tear. These factors may increase your risk:

  • Family history of shoulder problems or rotator cuff injuries.
  • Poor posture.
  • Smoking.
  • Being age 40 or older.

 

Degenerative tears are more common among people who do the same repetitive shoulder movements, such as:

  • Carpenters.
  • Mechanics.
  • Painters.
  • Recreational and professional athletes who play baseball, softball and tennis or are part of a rowing crew. 

 

What are the symptoms of a rotator cuff tear?

Sudden tears from accidents cause immediate, intense shoulder pain and arm weakness. With degenerative tears, you may have mild pain that improves with over-the-counter pain relievers. Over time, the pain gets worse, and pain relievers don’t help. Not everyone has pain, but most people have some degree of arm and shoulder weakness.

Signs of a rotator cuff tear include:

  • Difficulty and pain caused by raising your arm.
  • Popping or clicking sounds or sensations when moving your arm.
  • Shoulder pain that worsens at night or when resting your arm.
  • Shoulder weakness and struggling to lift items.

 

What are the complications of a rotator cuff tear?

A rotator cuff tear can get worse without treatment. A complete tear can make it almost impossible to move your arm. Without treatment, you may have chronic shoulder pain and find it very difficult to use the injured arm.

 

What are nonsurgical treatments for rotator cuff tears?

Rotator cuff tears do not heal on their own without surgery, but many patients can improve functionally and decrease pain with nonsurgical treatment by strengthening their shoulder muscles. Just because there is a tear, does not necessarily mean a surgery is needed. About eight out of 10 people with partial tears get better with nonsurgical treatments. It can take up to a year for the condition to improve.

Nonsurgical treatments include:

  • An arm sling and rest to give your shoulder time to heal. You may need to modify activities and stop certain work or sports for a period of time.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to minimize pain and swelling.
  • Physical therapy to learn strengthening and stretching exercises.
  • Steroid injections to ease pain and swelling.

 

When should I call my healthcare provider?

You should call your healthcare provider if you experience:

  • Chronic shoulder and arm pain.
  • Pain that worsens at night or interferes with sleep.
  • Redness, swelling, or tenderness in the shoulder joint area.
  • Shoulder or arm weakness.
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