Rotator Cuff Tear

What is a rotator cuff tear?

The Rotator cuff tendon is a group of four muscles :

A rotator cuff tear is an injury to any of these four muscles individually or combined together. Injury causes shoulder pain and the inability to use your arm.

The key function of rotator cuff is  to move the shoulder joint in front elevation, side lifting (abduction) and external and internal rotation of shoulder joint. In addition to providing shoulder moments, rotator cuff keeps the ball of your upper arm bone (Humeurs) in the Glenoid (shoulder blade socket).

Shoulder joint  is a ball-and-socket joint. It’s like a golf ball sitting on a golf tee. Rotator cuff tears occur when tendons pull away from arm bone.

Types of rotator cuff tears?

Types of torn rotator cuffs include:

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Partial

With an incomplete or partial tear, some part of tendon still attaches to your (humerus) arm bone

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Complete

With a full-thickness or complete tear, tendon tears and separates completely from humerus bone.

How common are rotator cuff tears?

Rotator cuff tears affect people of all ages, but the problem is more common in adults and these tears are usually degenerative.

Symptoms

Rotator cuff tear symptoms include:

When to see a doctor

Seek immediate care if any injury to your knee causes signs or symptoms of an ACL injury. It is wise to get a prompt and accurate diagnosis to determine the severity of the injury and get proper treatment.

Some patients feel a dull ache deep within your shoulder, or it may feel like sudden sharp pain as if  hit by a knife. Sudden tears from accidents or trauma cause immediate, intense shoulder pain and arm weakness. With degenerative tears, you may have mild pain that improves with pain killers. Over time, the pain gets worse, and pain relievers don’t help. Few patients are without any pain, but most people have some degree of arm and shoulder weakness.

Accident, fall from height, can cause tears your rotator cuff.

More commonly, rotator cuff tears occur over time as your tendon wears down with age and use (degenerative tear). People over age 40 are most at risk.

Causes of degenerative tears include

Bone spurs: Bony growths can form on the top of your shoulder bone. These bone spurs rub against your tendon when you lift your arm. This creates friction between your bone and tendon. Eventually, a partial or complete tear may occur.

  • Decreased blood flow:Blood flow to your rotator cuff decreases as you get older. If blood doesn’t nourish tendons, then it can cause tear.
  • Overuse: Repetitive shoulder movements during sports or on the job can stress your muscles and tendons, causing a tear.

Anyone can experience a rotator cuff tear. These factors may increase your risk:

  • Biological family history of rotator cuff injuries.
  • Poor posture.
  • Smoking
  • Age 40 or older.

Degenerative tears are more common among people who do the same repetitive shoulder movements, such as:

  • Electricians
  • Carpenters
  • Mechanics
  • Recreational and professional athletes who play badminton, Volleyball, basketball and tennis or are part of a rowing crew.

Diagnosis

A physical exam is the first step to diagnosing rotator cuff injuries. During the exam, a healthcare professional will examine shoulder joint and move the arm into different positions and access the strength of the muscles around the shoulder joint.

Imaging tests also may help diagnose rotator cuff injuries. Imaging tests may include:

The outcome of ACL injury can be that  there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact which is ACL sprain.

Complications

Without treatment, rotator cuff problems may lead to permanent loss of motion or weakness of the shoulder joint and in long term it can lead to shoulder joint arthritis.

Management & Treatment

What is the treatment for a rotator cuff tear?

Rotator cuff tear treatment may include nonsurgical and surgical options.

Nonsurgical Options

Rotator cuff tears don’t heal on their own without surgery, but many people can improve functionally and decrease pain with nonsurgical treatment by strengthening their shoulder muscles. Just because you have a tear doesn’t necessarily mean you need surgery, as many people have rotator cuff tears and don’t even know it. About 8 out of 10 people with partial tears get better with nonsurgical treatments. It can take up to a year for the condition to improve.

Nonsurgical treatments include:

Treatment

Conservative treatments — such as rest, ice, brace followed by physical therapy  is usually enough to  recover from minor rotator cuff injury.

In case injury is severe and rotator  cuff  tear is complete or high grade tear then conservative or non-operative methods might not be able to heal torn rotator cuff tissue and an arthroscopic surgery might be needed to repair the rotator cuff tissue.

Therapy

Physical therapy is usually one of the first treatments suggested. Exercises tailored to the specific location of your rotator cuff injury can help restore flexibility and strength to your shoulder. Physical therapy also is an important part of the recovery process after rotator cuff surgery.

Injections

An injection into the shoulder joint might be helpful. Injections are especially helpful if the pain is interfering with sleep, daily activities or physical therapy. While such shots often provide temporarily relief, they also can weaken the tendon and reduce the success of future shoulder surgery.

Surgery

Arthroscopic rotator cuff repair

Many different types of surgeries are available for rotator cuff injuries, including:

What is the rotator cuff tear recovery time?

After surgery, you need to wear a sling to immobilize your arm for four to six weeks. You can then start physical therapy. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 10-12 months.

Prevention

How can I prevent a symptomatic rotator cuff tear?

To prevent a rotator cuff tear, it’s important to keep your muscles and tendons flexible. Your sports injuries specialist doctor can teach you strengthening and stretching exercises to do at home.

When should I consult the doctor ?

If you experience:

Conclusive note

If you’re an athlete or have a physical job, a rotator cuff injury might incapacitate your shoulder joint, but it doesn’t have to be the end of your career. Talk to your healthcare provider about the best treatment options, whether nonsurgical or surgical. Your shoulder may be weak and painful for some time initially, but it’ll eventually heal.