A rotator cuff tear is the most common cause of chronic shoulder pain. In 2013, nearly 2 million people in the U.S. visited their healthcare provider due to a rotator cuff problem. A torn rotator cuff weakens the shoulder, making daily activities difficult to accomplish. If you think you are suffering from a rotator cuff tear, read on to learn about the different types, symptoms, and root causes, along with effective treatment options.
The shoulder is a ball-and-socket joint that consists of three bones: the collarbone (clavicle), the shoulder blade (scapula), and the upper arm bone (humerus). The rotator cuff keeps your arm attached in the shoulder socket and helps you rotate and lift the arm. Between the acromion (bone on top of your shoulder) and the rotator cuff is a lubricating sac known as a bursa. If there is a tear in your rotator cuff, which means the tendons are damaged or injured, the bursa will become painful and inflamed.
When the rotator cuff tendon is torn, it is no longer fully attached to the head of the upper arm bone. In many cases, a rotator cuff tear occurs in the supraspinatus tendon, but other tendons may also be involved. Damaged tendons start by fraying and can completely tear as the injury worsens.
Rotator Cuff Strain vs. Tear
Knowing the difference between a rotator cuff strain and a tear may save you from a treatment program that will not resolve your symptoms. In fact, using the wrong treatment method will only worsen your discomfort and reduce your chance of regaining full shoulder function.
A rotator cuff strain means the tendons are overstretched. It implies damage to a muscle or its attaching tendons. A rotator cuff tear, on the other hand, involves ripping (part or all) of the muscle fibers and the tendons attached to the muscle.
Types of Rotator Cuff Tears
Rotator cuff tears range from mild to severe. Understand the different types to receive proper diagnosis and treatment. The most common rotator cuff tear injuries tend to fall into one of three categories.
1. Partial Rotator Cuff Tear
In a partial rotator cuff tear, the tendon that protects the top of your shoulder is damaged or frayed, but is not completely severed. The rotator cuff is very thick, and this type of injury happens when a portion of the rotator cuff pulls away from the bone.
2. Full Thickness Rotator Cuff Tear
A full thickness rotator cuff tear is also called a complete rotator cuff tear. This type of injury separates all the tendon from the bone, creating what is basically a large hole in the supraspinatus tendon.
3. Massive Rotator Cuff Tear
In a massive rotator cuff tear, two of the four muscles are damaged and are no longer attached to the humerus. The injury may cause significant pain, especially at night, which can become unbearable. Some patients with massive tears report that the injury happens slowly. The muscle atrophies, and the tear retracts.
Causes of Rotator Cuff Tear
When the rotator cuff is torn, a variety of serious problems arise. How do you tear your rotator cuff? The two main causes of rotator cuff tear are:
1. Acute Tear
An acute rotator cuff tear is caused by an injury or trauma, such as lifting something too heavy or falling on your outstretched arm. This type of tear can happen with other serious shoulder conditions, such as a dislocated shoulder or a broken collarbone.
2. Degenerative Tear
A degenerative tear is the result of wear and tear of the tendon, which happens slowly as you age. This is why people aged 40 and above are at greater risk. Rotator cuff tears are more common in the dominant arm. So if the patient has a tear in one shoulder, there is a chance that the opposite shoulder is damaged as well, even if there are no symptoms present. Many factors contribute to a degenerative rotator cuff tear. These include bone spurs, repetitive stress, and lack of blood supply.
Rotator Cuff Tear Symptoms
If you are worried that you may have a rotator cuff tear, you should know what symptoms to watch out for. If you experience one or more of the most common rotator cuff tear symptoms, consult your doctor immediately.
Weakness when rotating the arm
Discomfort while resting and at night
Intense pain when lowering or lifting the arm
Pain that radiates through the affected arm
A popping or crackling sensation
Waking up with a dull ache deep in the shoulder
Difficulty combing your hair or reaching behind your back
Pain when getting dressed
Rotator Cuff Tear Diagnosis
See your doctor right away if you are experiencing any of the symptoms listed above. Early and accurate rotator cuff tear diagnosis is necessary to regain shoulder function and relieve your pain. Your doctor will use the following methods to diagnose your rotator cuff tear.
Medical History and Physical Examination
Your doctor will ask about your medical history, general health, and symptoms before performing a rotator cuff tear test to check your shoulders for deformity or tenderness. Your doctor will also evaluate your arm strength.
To test your range of motion, expect your arm to be moved in different directions. Decreasing strength may indicate that the tear is getting larger. To ensure your chronic pain is not caused by a pinched nerve or arthritis, your doctor may also examine your neck.
Rotator Cuff Tear X-Ray
The first imaging test to be conduct is often an X-ray, which produces images to determine whether the humeral head (top of your arm bone) is pushing into your rotator cuff area.
Rotator Cuff Tear MRI
An MRI scan can better show the rotator cuff tear, giving your doctor a clear image of how recent the injury is. This diagnostic imaging study can display the health of the rotator cuff muscles, the size of the tear, and where the injury is located within the tendon.
An ultrasound can help your doctor diagnose your rotator cuff tear. This test shows the soft tissues (the bursa, tendons, and muscles) in your shoulder.
Rotator Cuff Tear Treatment
Using your shoulder with a rotator cuff tear can result in further damage. A tear, when left untreated, can get larger over time and may result in chronic arm and shoulder pain. Without the right treatment program, rotator cuff tears may cause permanent stiffness or weakness. Talk to your doctor immediately, and try the below treatments for rotator cuff tear recovery.
To improve shoulder function, avoid activities that cause pain. Although resting for several days is necessary for your recovery, do not keep your affected shoulder immobilized for a prolonged period of time.
Nonsteroidal anti-inflammatory drugs, such as naproxen and ibuprofen, may reduce swelling and pain. Only take the recommended dose, and discuss any new medications with your doctor.
If medications and rest do not ease your pain, an injection of a local anesthetic and a cortisone preparation may help. However, this anti-inflammatory medicine is not effective for everyone.
Rotator Cuff Tear Brace
Talk to your doctor about using a shoulder support to improve your comfort and to prevent further damage. A universal shoulder brace is a safe and effective way to relieve pain and discomfort caused by a rotator cuff tear. It supports the rotator cuff to improve stability and protects your fragile shoulder.
Using a good shoulder brace is crucial for preventing further damage to your fragile rotator cuff. ( See Product )
An arm sling alleviates pain caused by tears and strains. Look for a sling with an ergonomic design, which evenly distributes weight to lessen discomfort in the shoulders. How long you will need to wear an arm sling depends upon the severity of your rotator cuff tear.
An arm sling keeps your shoulder safe and secure while your torn rotator cuff heals. ( See Product )
Rotator Cuff Tear Exercises
Many muscles are involved in shoulder movement, and they all work together, which is why strengthening the rotator cuff is particularly important. Once it is no longer painful to move your arm and swelling has gone down, perform simple exercises for rotator cuff tears to help you heal and prevent re-injury.
If you are considering adding weight to your routine, use a light dumbbell or a resistance band. Consult your doctor before beginning any exercise program.
Step 1: Lean over, supporting your weight with your unaffected arm against a chair or table.
Step 2: Relax your injured arm and let it hang straight down.
Step 3: Slowly swing your affected arm in circles. Reverse the direction.
Step 4: Swing your arm forward and backward.
Step 5: Perform this exercise at least 3 times per day, for 5 to 10 minutes.
Step 1: Stand in an open doorway, with your arms at your sides.
Step 2: Hold the doorframe with each hand at shoulder height, or as high as you can.
Step 3: Lean your bodyweight forward through the doorway. You should feel a stretch in the front of your shoulder.
Step 4: Shift your weight onto your toes, keeping your back straight. Breathe in and out. Hold this position for 15 to 30 seconds.
Step 5: Perform 2 to 3 repetitions per day. This exercise keeps your muscles warm.
Lawn Mower Pull
Step 1: Start with your feet shoulder-width apart.
Step 2: Put one end of a resistance band under the foot opposite your affected arm. Grab the other end with your injured arm, so the resistance band runs diagonally across your body.
Step 3: Place your other hand on your hip, then slowly bend your knees.
Step 4: As you stand, slowly pull the band like you are starting a lawn mower. Squeeze your shoulder blades together.
Step 5: Build up to 3 sets of 10.
Step 1: Stand with your feet shoulder width-apart. Bend your knees slightly.
Step 2: Lean forward at the waist, keeping your back straight.
Step 3: With a lightweight dumbbell or a can of soup in each hand, extend your arms and lift them away from your body. Do not raise your arms above shoulder height.
Step 4: Squeeze your shoulder blades together, without locking your elbow.
Step 5: Perform 2 sets of 10.
Lateral Rotation in Abduction
Step 1: Stand with your feet shoulder-width apart.
Step 2: Hold a resistance band with your affected arm raised out to the side of your body and your elbow at 90 degrees.
Step 3: Slowly pull the band toward the ceiling. Squeeze your shoulder blades, and keep your back straight.
Step 4: Return to the starting position and relax.
Step 5: Build up to 2 sets of 10.
Rotator Cuff Tear Surgery
A major injury needs more attention. Once your doctor has diagnosed your rotator cuff tear, an orthopedic surgeon will review both nonsurgical and surgical options and begin treatment. If your symptoms have lasted six to twelve months, your doctor may recommend rotator cuff tear surgery. Continued pain, significant weakness, and loss of function in your shoulder may require this procedure.
There are several options for surgically repairing rotator cuff tears. These include open repair, all-arthroscopic repair, and mini-open repair. The appropriate surgical method depends on several factors, such as your anatomy, the size of your tear, the quality of the bone and tendon tissue, and the surgeon’s familiarity and experience with a particular procedure. Some surgical methods are time-sensitive, so see a shoulder specialist as soon as possible.
Rotator cuff tear recovery takes approximately four to six months, but recovery time depends on the size of the tear and other key factors. In some cases, six months or more of rehabilitation is required to regain shoulder strength, function, and a full range of motion. The smaller and more recent the tear, the higher your chances of being pain-free quickly. Complete recovery is a gradual process, so be patient.
Prevent a Tear in Rotator Cuff
The best options for treating and preventing a rotator cuff muscle tear are different for each person. Follow your doctor’s instructions, and follow up regularly. Don’t forget to use a high-quality brace to protect your shoulder from injury or re-injury, and never push your joint past its comfort zone.
Jessica Hegg is the content manager and at ViveHealth.com. With vast product knowledge and understanding of individual needs, she aims to share valuable information on making smart buying choices, overcoming obstacles and overall improving the quality of life for others. Avid gym-rat and nutrition enthusiast, she’s interested in all things related to staying active and living healthy lifestyle.
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