More About Rotator Cuff Injuries

What Is a Rotator Cuff Tear?

The shoulder girdle includes three bones (scapula, clavicle, and humerus) and three joints (glenohumeral, acromioclavicular, and sternoclavicular). The shoulder has a greater range of motion than any other joint. It’s also more likely to get injured.

The large, powerful deltoid muscle gives shoulder motion most of the power. Underneath this muscle are four rotator cuff muscles (subscapularis, supraspinatus, infraspinatus, and teres minor). They fine-tune shoulder movement and make the shoulder more stable. These muscles attach to bones by tendons. The rotator cuff is made up of muscles and tendons that hold the upper arm in the shoulder joint. A rotator cuff tear is a partial- or full-thickness tear of one or more rotator cuff tendons. It’s fairly common.

What Causes a Rotator Cuff Tear?

The cause is trauma throughout one’s lifetime. The tendon touches a bone spur in the shoulder. Tears usually occur during activities or jobs in which the arm is often moved over the head or raised and lowered. Playing baseball, swimming, and tennis are such activities. House painting and carpentry are such jobs.

What Are the Symptoms of a Rotator Cuff Tear?

The main symptom is shoulder pain, especially when moving the arm sideways up over the head. Pain gets worse with overhead activities such as hair brushing. The arm and shoulder may feel weak. Other symptoms include shoulder pain that worsens when lying down. Pushing objects away from the body can hurt, but pulling them does not. A tear in the rotator cuff tendon itself makes the shoulder much weaker, and it’s hard to do any overhead activities.

How Is a Rotator Cuff Tear Diagnosed?

The health care provider will make a diagnosis from a history and physical examination, especially of the shoulder and back. The health care provider puts the shoulder through ranges of motion that cause pain. The health care provider will want the arm moved in specific ways. Magnetic resonance imaging (MRI) can help confirm the diagnosis.

How Is a Rotator Cuff Tear Treated?

A partial rotator cuff tear can usually be helped with nonsurgical methods. The health care provider may prescribe medicines such as nonsteroidal antiinflammatory drugs (NSAIDs) to help inflammation and pain.

Exercise, specifically physical therapy, can help rotator cuff tendons of the shoulder get stronger and reduce pain. Ice packs put on the shoulder after exercise reduce pain and inflammation.

When physical therapy doesn’t work or a full tear is present, surgical decompression may be used. The torn tendon may be fixed with an open or arthroscopic procedure. Surgery involves removing the undersurface of the acromion, fixing other inflamed parts, and repairing the rotator cuff tear.

DOs and DON’Ts in Managing Rotator Cuff Tear:
  • DO take your medications as prescribed.
  • DO try to do tasks with your unaffected arm.
  • DO your exercises as directed.
  • DO call your health care provider if pain is bad enough to stop you from sleeping at night and isn’t helped with over-the-counter medicines.
  • DON’T use addictive pain medicines as long-term therapy.
  • DON’T do activities in which you must use your hands above your head. Don’t do pushups. Don’t do strenuous sports while your shoulder heals.

Contact the following sources:

  • American Academy of Orthopaedic Surgeons
    Tel: (847) 823-7186, (800) 346-2267

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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