Rotator Cuff Tear

Your shoulder is a ball and socket joint. The rotator cuff is a group of muscles that come together as a tendon at the top of the head of the humerus (ball). The rotator cuff functions to lift and rotate the arm.

In the case of a rotator cuff tear the tendon is no longer attached to the head of the humerus. The suprasinatus tendon is the tendon that is most commonly torn. Tears can be full thickness or partial thickness.

Rotator cuff tears occur in two common ways- wear and tear (degeneration) and injury (trauma).

Rotator cuff tears can happen at any age. Those over the age of 40 are at a greater risk due to normal wear and tear. Athletes, those of do overhead activities, and those who work with heavy objects also at greater risk with traumatic injuries.

Symptoms of a rotator cuff tear include:

• Pain in the shoulder especially when sleeping on it at night
• Pain or weakness with lifting motions especially away from the body
• Crunching sounds with motion

Evaluation begins with discussing symptoms, medical history, a physical evaluation, and x-rays. Examination includes range of motion, strength testing, and specialized maneuvers to evaluate the shoulder. Occasionally the neck can be a cause of shoulder pain, such as with a pinched nerve, and this should be evaluated as well. Additionally, other conditions including arthritis should be evaluated. An MRI may be ordered to help evaluate the tear further for size and age.

If it is determined that there is a rotator cuff tear, treatment options may include the use of medication, injections, physical therapy, and arthroscopic surgery. Surgery is indicated for those whose pain does not improve with nonsurgical treatment and those who are active with sports, work, or overhead activity. Using a painful shoulder with a rotator cuff tear may lead to further damage and an increase in tear size.

Treatment is aimed at reducing pain and increasing strength and motion. About fifty percent of people find pain relief and increased function with nonsurgical treatments; however, in a traumatic tear strength likely will not return.