What is a Rotator Cuff Tear?
A rotator cuff (RTC) tear is a common shoulder problem that people consult with a physician for, especially in patients older than 60 years of age. The rotator cuff is a group of four muscles in the shoulder that enable people to lift things above their head and have strength. Tears of the rotator cuff usually happen where the muscle attaches to the bone, called the tendon. This can result in difficulty lifting your arm above your shoulder, having weakness, and difficulties doing daily tasks like combing your hair or getting dressed.
Mechanism of Injury
The rotator cuff tear is commonly a tear that happens over a long period of time due to degeneration or fraying that occurs over decades of life. This can occur in those younger individuals as well due to repetitive tasks, work, traumatic injuries and sometimes with sporting injuries. Some individuals can even sustain a tear of the rotator cuff without any preceding event.
Diagnosis and Symptoms of a RTC Tear/sprain
The common symptoms of a RTC tear and sprain include significant shoulder discomfort, dysfunction, and pain that can be worse at night. These tears can lead to difficulty lifting your arm above your shoulder, weakness when lifting objects, pain with certain rotations and can cause popping or cracking in the shoulder. The rotator cuff can vary significantly in severity of symptoms and some may not even have any pain at all. These can occur as an acute injury, like a fall or traumatic event, but most commonly occur over a long period of time with gradual wear and progressive symptoms.
This can be diagnosed on a physical exam with inability to push against resistance and demonstrating significant weakness. X-rays are part of the initial evaluation to evaluate the architecture of the shoulder and evaluate for arthritis, fractures and other common shoulder issues. Advanced imaging studies, ultrasound, CT scans and MRIs, can be useful to help fully diagnose the full extent of the problem.
Treatment for a RTC Tear/sprain
The treatment for a RTC sprain is geared toward non-operative management to decrease pain/symptoms, increase motion and regain function. Modalities are used to expedite recovery and can include anti-inflammatories, icing, injections, and physical therapy. Small RTC tears can also be treated without surgery and return to full activities. Patients may require surgery if they do not progress using traditional non-operative therapies or have a larger RTC tear that is not amenable without surgery. Some patients are not candidates for surgery due to chronic retracted tears that are not repairable or for medical reasons. Surgery can be an effective management for RTC tears, although recovery can be as long as 9 months to a year.
For more information, please consider the following link that was produced by the AAOS.
https://orthoinfo.org/en/diseases–conditions/rotator-cuff-tears/