Rotator cuff tear
What is a rotator cuff tear?
Rotator cuff tears affect two million people in the U.S. each year, and is common in sports like baseball or tennis or in jobs like painting or cleaning windows. It often happens over time from normal wear and tear, if you repeat the same arm motion over and over, or if you have an accident that injuries the tendons.
There are several types of rotator cuff tears: partial, full-thickness, acute, and degenerative. The most common tear is in the supraspinatus muscle and tendon, which can cause inflammation of the acromion, resulting in additional pain.
What causes a rotator cuff tear?
A rotator cuff becomes torn when one of the tendons is injured, often from lifting something too heavy over the head or repetitive stress. When a rotator cuff is torn, the tendon no longer attaches properly to the top of the humerus bone.
A lack of blood supply to the area, caused with age, can also reduce the body’s natural ability to repair itself. If a tendon is already slightly injured and the blood supply is diminished, a tear can occur. Most rotator cuff tears are caused from a combination of repetitive and degenerative causes; those age 40 and older are most at risk.
During a physical exam, the physician will have the patient move the arm in specific directions to determine the source of the pain and may test for arm strength. X-rays are unable to show soft tissue, so an MRI and ultrasound will likely be ordered to confirm the tear diagnosis.
The MRI should provide the size and location of the tear, and the physician may be able to determine how old the injury is. A pain physician will also rule out arthritis and/or a pinched nerve during examination.
Degenerative symptoms include: pain if lying on the shoulder at rest, or when lifting and lowering the arm; weakness in the limb, especially when rotating the arm; or a crackling noise when moving the arm.
When a tear is caused from a sudden injury, such as falling off a ladder or a car accident, there may be a snapping noise, followed by intense pain and weakness in the arm.
Non-surgical treatment for rotator cuff tears include rest, avoiding activities that cause pain, taking non-steroidal anti-inflammatory over-the-counter medications like Aleve, participating in physical therapy, or receiving steroid injections.
Half of all rotator cuff tear patients report pain relief without surgery; however, these options do not improve the strength of the shoulder, they only minimize pain. If a patient’s pain doesn’t improve, the physician may recommend surgery to repair the tendon and tear.
Procedures / Surgeries
Below are various procedures for the treatment of Rotator cuff tear.