Shoulder

Rotator Cuff Tear

Rotator cuff tears get a lot of attention. They’re relatively common in people over 40 and can result from overuse or a single traumatic event. There are many types and levels of rotator cuff tears.

When a tear is the result of a trauma, the pain, discomfort, and weakness is profound and leads most patients to early evaluation and treatment. Patients with tears that are the result of overuse often cope with the condition for many weeks or months before seeking treatment.

Rotator cuff tears as a result of overuse are most common in older individuals and athletes competing in overhead sports such as baseball, tennis, basketball, golf, and swimming. Tears resulting from trauma are typically attributed to falls or collision sports such as football, lacrosse, and ice hockey. It is also very common to tear one or more of the rotator cuff tendons when you dislocated your shoulder.

Symptoms

  • Pain with some or all motions
  • Aching pain at night and after use
  • Weakness with activities, especially overhead
  • Trouble sleeping
  • Limited motion secondary to pain or weakness
  • Clicking or popping

Diagnosis

A torn rotator cuff can typically be diagnosed through physical examination and X-rays. More advanced tears or questionable tears may require an MRI to determine the location and extent of the injury.

Treatment

Once a rotator cuff tear is diagnosed, physical therapy often begins immediately. The initial focus is on reducing pain, then you will work to regain motion and function of the shoulder.

To reduce pain, your doctor may recommend anti-inflammatories and Tylenol during the early stages. Alternative treatments can include glucosamine, hyaluronic acid, and non-steroidal anti-inflammatory medications (NSAIDs).

If the tear is more serious, conservative measures fail, or you would like to return to a high level of sporting activity, surgery may be recommended. Early surgical intervention is often a good fit for younger individuals who have experienced a traumatic, full thickness tear. For older patients or anyone with an overuse/degenerative tear, surgery is typically delayed until conservative measures have been applied.

Rotator cuff surgery involves the reattachment of the the torn tendons. The repair can often be performed arthroscopically. Repairs are successful when both the tendon quality is good and the repair is done without significant tension. Rehabilitation after surgery is very important. A period of time with no motion is typically recommended, followed by a longer period of passive motion. Once the repair has healed, rehabilitation and normal daily activities can begin.