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Rotator cuff tears are a common cause of shoulder pain. When you tear your rotator cuff, certain movements like lifting and rotating your arm can be painful.
Rotator cuff pain can affect daily life and simple tasks like getting dressed. It can also be a frustrating injury for athletes.
Tears can happen slowly or suddenly, such as from a fall. Some rotator cuff injuries heal with rest. Others require treatment or even surgery.
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The rotator cuff refers to a group of muscles and tendons in the shoulder joint. These muscles and tendons cover the top of your upper arm bone and let you to raise and rotate your arm.
Doctors define a torn rotator cuff as a tear of one or more of the tendons that cover this bone (the humerus). A torn rotator cuff means the tendon is pulling away from the humerus.
A torn rotator cuff is a common injury. Every year, about 2 million people see their doctor for rotator cuff pain. For some, it's a nagging pain. For others, the pain is sudden and from an injury.
A torn rotator cuff can be partial or total.
Common causes of a severe tear in the rotator cuff can include:
People also tear rotator cuffs from overuse. This is called a degenerative tear and happens over time, as you have wear and tear on the tendon.
Activities that require an overhead motion of the arm and rotation of the joint can lead to a tear. Sports that involve repetitive motion often cause rotator cuff pain. Some of these sports include baseball, tennis, racquetball, rowing, weightlifting, and gymnastics.
Your job may also put you at risk for injuring your rotator cuff if you repeat the same shoulder motions each day.
A rotator cuff tear is more likely to occur under certain circumstances.
These risk factors include:
If left untreated, a rotator cuff tear can severely restrict function and range of motion.
The tear can also increase over time. This may cause partial rotator cuff tears to progress to total tears.
While anti-inflammatory drugs can ease pain at the beginning of the injury, time worsens the tear and makes these medicines less effective.
Rotator cuff tears from trauma — like a fall or a blow — will often cause intense pain and the rapid onset of symptoms. You will usually know something is wrong right away because of the pain.
Tears from wear and tear may have a slower progression of pain and symptoms. At first, over-the-counter medicines like ibuprofen or aspirin may relieve pain. But with time, the pain may be more persistent and bother you even when you're at rest.
The most common symptoms of rotator cuff injuries include:
You can cause more damage and make a tear worse if you keep using your shoulder. If you have pain that keeps getting worse and/or doesn't improve with rest, seek care.
The assessment of a suspected torn rotator cuff is most helpful at the first sign of repeated symptoms. This allows your doctor to catch the tear before it progresses.
To diagnose a rotator cuff tear, your doctor will:
Based on these results, you may need other tests such as:
Although tailored to your symptoms, treatments for rotator cuff tears aim to:
Based on how serious your rotator cuff injury is, your doctor may choose nonsurgical or surgical treatments.
According to the American Academy of Orthopaedic Surgeons, nonsurgical treatments for rotator cuff tears relieve pain and increase function half the time.
Nonsurgical treatments generally begin with resting and not moving your shoulder.
If symptoms persist, your doctor may recommend:
If you still have rotator cuff tear symptoms — even after trying nonsurgical treatments — your doctor may suggest rotator cuff repair surgery.
Factors that may make rotator cuff surgery a better option than nonsurgical treatments include the:
The three common surgical techniques for repairing rotator cuff tears are:
Treatments for rotator cuff injuries, when started as quickly as possible, can:
For these reasons, you should talk to your doctor right away if you think you have a shoulder injury.
After rotator cuff surgery, you should expect a slow return to normal.
At first, you may have to use a sling and avoid motion for four to six weeks. But, in time, you will bring movement and lifting back into your routine.
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