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The rotator cuff is made up of muscles and four tendons that surround the shoulder joint. Whether from a direct blow or from repetitive motion over time, injuries to the rotator cuff cause the tendons to tear and become damaged.
A rotator cuff injury may be caused by:
Athletes in sports that use a lot of repetitive overhead arm motion are at a higher risk of getting a rotator cuff injury. People over age 40, people who do a lot of heavy lifting, or people with weakened shoulder muscles from inactivity are also at higher risk.
To help prevent tearing the rotator cuff, avoid heavy lifting and try to give your arm and shoulder a break from repetitive motions. Exercise regularly to keep the muscles around your shoulder joint strong.
When a rotator cuff injury happens immediately, like from a fall, there will be intense pain. Tears that develop over time will have symptoms progress more slowly.
Rotator cuff tear symptoms and signs include:
To diagnose a rotator cuff tear, a doctor will take a medical history and perform a physical exam in which you will be asked to move your shoulder. You doctor will look at your range of motion and discuss the amount of pain you are having.
Tests you may need include:
Your diagnosis will be based on how badly the rotator cuff is torn. You may have a partial or total tear. A partial tear means the rotator muscles are not severed completely. With a total tear, the muscles are completely split apart.
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 properly heal.
The goals of treatment are to:
Recovery time can take anywhere from several weeks to several months, and varies depending on the severity of the tear. In cases where surgery is needed, your doctor will discuss your recovery time and plan with you in detail.
For minor tears, you need to give your shoulder a break and let the muscles heal on their own. Your doctor may recommend:
After your symptoms have subsided, your doctor may recommend physical therapy to strengthen your rotator cuff and the surrounding muscles.
For a major tear, or if your symptoms don't get better after nonsurgical treatment, your doctor may recommend surgery. There are a couple options ranging from open surgery to less-invasive surgery. You and your surgeon will discuss the best way to treat your specific injury.
To properly recover from surgery, you may need to wear a sling for about four to six weeks afterward to limit motion in your shoulder. That is followed by physical therapy to regain strength and range of motion.
The sooner you get treatment, the better your chances of stopping the tears from worsening and safely returning to activity.