Rotator Cuff Tears
A rotator cuff tear is a common cause of shoulder pain and disability, particularly in adults. The risk of this condition increases with age, but it can also occur from injury or overuse. The rotator cuff is made up of four muscles and tendons that connect the shoulder blade (scapula) to the upper arm bone (humerus). These structures work together to stabilize the shoulder and allow for a wide range of motion.
A rotator cuff tear occurs when one or more of these tendons becomes damaged and detaches, either partially or completely, from the bone.
What Causes a Rotator Cuff Tear?
Rotator cuff tears can occur in two primary ways:
- Acute tears: Caused by a sudden injury, such as a fall or lifting something heavy
- Degenerative tears: Develop over time due to gradual wear and tear of the tendon
Degenerative tears are more common and often occur as part of the natural aging process.
Symptoms of a Rotator Cuff Tear
Symptoms can vary depending on the severity of the tear but commonly include:
- Pain when lifting or lowering the arm
- Pain at rest or at night
- Weakness in the shoulder
- Difficulty performing overhead activities
These symptoms may gradually worsen over time if left untreated.
Diagnosis
A rotator cuff tear is typically diagnosed through a physical examination of the shoulder. Imaging, such as an MRI, may be used to confirm the tear and evaluate its size and severity.
Treatment Options
Treatment depends on the size of the tear, symptom severity, and your activity level.
Non-Surgical TreatmentMany patients experience improvement without surgery. Non-surgical options may include:
- Rest and activity modification (while maintaining gentle movement to prevent stiffness)
- Anti-inflammatory medications (such as ibuprofen or naproxen)
- Physical therapy to strengthen and stretch surrounding muscles
- Cortisone (steroid) injections to reduce inflammation and pain
While these treatments can improve symptoms, the tear itself does not heal and may increase in size over time. Some patients may also experience ongoing weakness.
Surgical TreatmentSurgery may be recommended if:
- Symptoms persist despite conservative treatment
- Pain or weakness interferes with daily activities
- The tear is large or worsening
Surgical treatment involves reattaching the tendon to the bone using sutures. This is the only way for the tendon to heal.
Recovery includes: A structured rehabilitation program and physical therapy to restore strength and motion over time.
Risks and Outcomes
Rotator cuff surgery is often successful in relieving pain and improving function. However, as with any surgical procedure, there are potential risks, including:
- Infection
- Shoulder stiffness
- Continued pain
- Re-tearing of the tendon
Factors such as smoking, advanced age, and not following the rehabilitation plan can increase the risk of complications.
Frequently Asked Questions
No. The tendon does not heal on its own, but symptoms can often be managed with non-surgical treatment.
Surgery may be recommended if pain, weakness, or limited function persists despite conservative treatment.
Recovery varies, but most patients require several months of rehabilitation to regain strength and motion.
Yes, many people continue to use their shoulder, but pain and weakness may limit certain activities.
In some cases, the tear can increase in size over time, particularly if left untreated or if symptoms persist.
Schedule an appointment today to discuss your symptoms and explore treatment options tailored to your needs.
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