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Rotator Cuff Tear or Injury

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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What Is a Torn Rotator Cuff?

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.

What are the types of rotator cuff tears?

A torn rotator cuff can be partial or total.

  • A partial tear doesn't cause the rotator muscles to sever completely.
  • A total tear — also known as a full-thickness tear — completely severs the muscles to where they split in two.

What Causes a Rotator Cuff Tear?

Common causes of a severe tear in the rotator cuff can include:

  • Trauma to the shoulder from a direct blow.
  • Falling on an outstretched arm.
  • Lifting something too heavy with a jerking motion.

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.

What are the risk factors of rotator cuff tears?

A rotator cuff tear is more likely to occur under certain circumstances.

These risk factors include:

  • Playing sports, such as baseball, swimming, or tennis.
  • Work or sports that stress repetitive overhead arm motion.
  • Age greater than 40 years old.
  • Heavy lifting.
  • Weakened shoulder muscles from reduced (or lack of) activity.

What are the possible rotator cuff tear complications?

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.

Why Choose UPMC Orthopaedic Care for Rotator Cuff Tear Treatment?

  • UPMC has one of the highest-funded orthopaedic research departments in the nation, with access to ongoing clinical trials, particularly useful for those seeking repair of a rotator cuff tear.
  • We offer expert orthopaedic surgery services and treatments to people of all ages to help them get back to enjoying their lives.

Torn Rotator Cuff Symptoms and Diagnosis

What are the symptoms of a torn rotator cuff?

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:

  • Pain with motion and at rest, especially at night, if you lie on your shoulder.
  • Muscle weakness, especially when you lift or reach.
  • Popping or clicking sounds during motion.
  • Limited range of motion of your shoulder.

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.

How do you diagnose a rotator cuff tear?

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:

  • Gather your complete medical history, focusing on prior shoulder and muscle injuries.
  • Do a physical exam.
  • Ask you to move your shoulder while observing muscle movements and asking about pain intensity.

Based on these results, you may need other tests such as:

  • X-rays using imaging techniques to examine your shoulder.
  • Magnetic resonance imaging (MRI) using magnets and radio waves to take pictures of the inside of the shoulder.
  • Ultrasound using sound waves to check the rotator cuff for swelling or tears.

Rotator Cuff Tear Treatment and Surgery

Treatment goals for rotator cuff tears

Although tailored to your symptoms, treatments for rotator cuff tears aim to:

  • Stop further tearing of the rotator cuff.
  • Stabilize the shoulder joint.
  • Manage pain.
  • Let you return to your normal routine.

Based on how serious your rotator cuff injury is, your doctor may choose nonsurgical or surgical treatments.

Types of treatment for torn rotator cuffs

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:

  • Anti-inflammatory drugs.
  • Ice or compression.
  • Physical therapy.

Rotator cuff surgery

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:

  • Length of symptoms.
  • Size of the rotator cuff tear.
  • Severity of muscle weakness.

The three common surgical techniques for repairing rotator cuff tears are:

  • Open repair — this method is invasive but allows your surgeon to see the scope of your shoulder muscles.
  • All-arthroscopic repair — this method uses a surgical camera and guides surgical tools to make a small incision and repair your muscles.
  • Mini-open repair — this method combines the first two strategies.

Benefits and risks of rotator cuff tear treatment

Treatments for rotator cuff injuries, when started as quickly as possible, can:

  • Stop the progression of current tears.
  • Rehabilitate tears.
  • Preserve mobility.

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.

Learn more about rotator cuff tears and injuries

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