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Rotator Cuff Tear

A rotator cuff tear impacts the muscles and tendons surrounding the shoulder joint. This common injury often leads to pain and difficulty in arm movement, significantly affecting daily activities. Simple tasks like getting dressed can become challenging.

If you have shoulder pain and limited arm mobility, it's crucial to see your doctor to prevent further harm to your shoulder joint, muscles, and tendons.

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What Is a Rotator Cuff Tear? 

A torn rotator cuff is a condition in which one or more tendons in the shoulder's rotator cuff group are torn, causing them to detach from the bone. These tendons, along with the associated muscles, play a crucial role in enabling you to move your arm. A torn rotator cuff typically results in pain and limitations in arm mobility and rotation.

How common are rotator cuff tears?

A torn rotator cuff is a frequent injury, affecting about 2 million people each year. Symptoms may vary, with some people experiencing persistent pain and others having sudden pain due to an injury.

What are the types of rotator cuff tears?

There are two types of rotator cuff tears:

  • Partial tear. A partial tear doesn't completely sever the rotator cuff muscles. While there's damage to the tendons, they remain partially intact.
  • Total tear. A total tear, also known as a full-thickness tear, completely severs the rotator cuff muscles, causing them to split into two separate parts.

What causes rotator cuff tears?

A rotator cuff injury can happen from:

  • Trauma. Direct blows to the shoulder can lead to severe tears in the rotator cuff.
  • Falling. Falling on an outstretched arm can cause significant damage to the rotator cuff tendons.
  • Lifting heavy objects. Attempting to lift something too heavy with a sudden, jerking motion can cause a tear.
  • Repetitive overhead motion. Doing repetitive overhead arm movements, such as those involved in some sports, can contribute to rotator cuff tears.
  • Degenerative wear and tear. Chronic degeneration of the rotator cuff tendons over time can lead to tears known as degenerative tears.
  • Overuse. Repetitive motion from overuse causes wear and tear on the tendons.

What are rotator cuff tear risk factors and complications?

Rotator cuff tear risk factors

Many factors may put you at risk for a rotator cuff tear, including:

  • Sports with overhead activities. Playing sports involving repetitive overhead arm motion, like baseball, swimming, or tennis, increases the risk of rotator cuff tears.
  • Occupation. Jobs that involve repetitive shoulder motions also can put people at risk for rotator cuff tears.
  • Age. People over age 40 are more prone to developing rotator cuff tears.
  • Heavy lifting. Lifting heavy items regularly can lead to tears.
  • Muscle weakness. Weakened shoulder muscles due to reduced activity or lack of exercise can increase the risk of rotator cuff tears.

Rotator cuff tear complications

It's important to note that untreated rotator cuff tears can lead to further complications, including chronic pain, limited arm functionality and range of motion, and potential damage to the shoulder joint. Seeking a proper diagnosis and treatment is vital to preventing these complications.

A tear also can increase over time — so a partial rotator cuff tear may progress to a total tear.

How can I prevent a rotator cuff tear?

To reduce the risk of tearing your rotator cuff, avoid heavy lifting and take breaks from repetitive arm and shoulder movements.

It's also crucial to maintain flexibility in your shoulder muscles and tendons. Your doctor may suggest strengthening and stretching exercises for you to do at home to keep your shoulder joint in good shape.

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What Are the Signs and Symptoms of a Torn Rotator Cuff?

Trauma-induced rotator cuff tears, such as those resulting from a fall or a blow, often lead to intense pain and a sudden onset of symptoms. Sudden and severe pain is a sign that something is wrong, and you should see a doctor right away.

Tears caused by wear and tear may have a slower progression of pain and symptoms. Initially, rest and over-the-counter medications like ibuprofen or aspirin may provide relief. But if the pain worsens or doesn't improve with rest, see your doctor for an exam.

Regardless of why you're having rotator cuff pain, continuing to use the injured shoulder might worsen the damage and tear.

The most common symptoms of rotator cuff tears include:

  • Pain during movement and rest, especially at night when you're lying on the affected shoulder.
  • Muscle weakness, especially when lifting or reaching.
  • A popping or clicking sound during movement.
  • Limited range of motion in the shoulder.

When should I see a doctor about my torn rotator cuff symptoms?

If you injure your shoulder, have chronic shoulder and arm pain, or suspect you have a rotator cuff tear, you should see your doctor.

Your rotator cuff won't heal on its own, especially if you keep trying to do what you normally do. However, early diagnosis and treatment of a rotator cuff tear can help prevent losing strength and range of motion in your shoulder.

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How Do You Diagnose a Rotator Cuff Tear? 

To diagnose a rotator cuff tear, your doctor will take your complete medical history, focusing on any previous shoulder or muscle injuries you've had. They'll also do a physical exam to assess your shoulder's range of motion and muscle movements while asking about the pain intensity.

Depending on the results of the exam, your doctor may need to run tests.

Tests to diagnose a rotator cuff tear

If your doctor suspects that you have a rotator cuff injury, they'll likely order imaging tests, such as an:

  • X-ray, which shows the structures of your shoulder.
  • MRI, which uses magnets and radio waves to create detailed images of the inside of your shoulder.
  • Ultrasound, which uses sound waves to assess the rotator cuff for signs of inflammation or tears.

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How Do You Treat a Torn Rotator Cuff?

To avoid long-term pain and limited use of your shoulder, you should treat any rotator cuff injury right away. Even a minor tear can worsen over time if not given the chance to heal.

Prompt treatment can:

  • Prevent further tearing.
  • Stabilize the shoulder joint.
  • Manage pain.
  • Allow you to return to activity.

The overall goals of rotator cuff treatment are to alleviate pain and enhance shoulder strength. Recovery time can take anywhere from several weeks to several months and varies depending on the severity of the tear.

Nonsurgical rotator cuff injury treatment

Most rotator cuff tears can't heal on their own. However, you can relieve pain and regain range of motion without surgery.

For minor tears, your doctor may suggest:

  • Immobilizing the shoulder to prevent further strain.
  • Applying ice packs for around 15 minutes, multiple times a day, to reduce swelling and pain.
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain.

Once your symptoms have improved, your doctor may recommend physical therapy to strengthen the rotator cuff and the surrounding muscles.

But in cases where the tear is severe or nonsurgical treatments don't give you relief, you may need surgery.

Rotator cuff tear surgery

Many tears don't heal without surgery. Your doctor may also recommend surgical treatment if you lead an active lifestyle and engage in overhead activities or sports.

Several surgical options are available, ranging from open surgery to less invasive techniques. Your orthopaedic surgeon will consider your pain level and the severity of the tear when making a treatment recommendation.

How effective is rotator cuff surgery?

After rotator cuff surgery, you should expect a slow return to normal. You might need to wear a sling for about four to six weeks to limit shoulder movement and help with recovery. Physical therapy will also help you regain strength and restore your range of motion.

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