Rotator Cuff Injuries or Tears

Overview

Rotator cuff injuries or tears are often caused by repetitive overhead motion that wears down and eventually tears the rotator cuff tendon. The rotator cuff is a group of muscles and tendons in the shoulder. The rotator cuff is responsible for holding the arm in its joint and facilitate shoulder movement.

In many cases, surgery is necessary to repair a torn rotator cuff tendon. Most patients need physical therapy after surgical treatment to help strengthen the rotator cuff area and support full healing and range of motion.

If the rotator cuff was injured in a traumatic incident, it is crucial to seek treatment right away.

Rotator cuff injury causes

Acute rotator cuff tears can be caused by sudden movements such as bracing a fall or raising an arm suddenly against resistance.

Chronic tears are usually seen in patients who perform overhead motions repeatedly in sports or their jobs, making them susceptible to tearing or injuring their rotator cuffs. 

Rotator cuff injury risk factors

You may be at an increased risk of tearing a rotator cuff if you:

• Perform overhead motions repeatedly in sports or your job.
• Are in an accident involving force and sudden movement, such as falling on an outstretched arm.
• Are older - Tendons will begin to degenerate with age. Therefore rotator cuff injuries increase with age.
• Have naturally loose joints or joints that move in more than one direction.
• Have a family history of rotator cuff injuries.

Rotator cuff injury symptoms

Symptoms of a torn rotator cuff include:

• Pain deep in the shoulder
• Difficulty sleeping due to pain when lying on the shoulder
• Difficulty performing certain motions such as brushing your hair or reaching backward
• Arm weakness

Rotator cuff injury complications

Complications arising from rotator cuff treatments may include:

• Stiffness or "frozen shoulder" post-treatment or surgery
• Infection inside the joint
• Continued pain
• Re-tear of the tendon
• Damage to nerves in the shoulder area
• Swelling and numbness
• Loss of range of motion and strength

Rotator cuff injury prevention

To lower your risk of tearing your rotator cuff:

• Avoid high risk and repetitive activities requiring overhead use of the shoulder joint
• Wear proper protective equipment during sports
• Avoid sudden movements against force or carrying heavy objects, particularly overhead
• Maintain strength and flexibility in muscles and joints

Rotator cuff injury diagnosis

Your doctor can diagnose a rotator cuff injury by performing a physical exam. During the exam, your docgtor will evaluate your shoulder and arm muscle strength.

In most cases, your doctor will also order diagnostic imaging tests to confirm the diagnosis, determine the extent of the injury, and evaluate the need for surgery. Imaging tests may include:

• X-rays
• Ultrasound
• MRI

Rotator cuff injury treatment

Treatment for rotator cuff may involve conservative therapies such as:

• Ice compressions
• Rest
• Physical therapy – there are specific exercises that strengthen your shoulder
• Anti-inflammatory pain medications

If your pain continues and is interfering with your daily activities, you may need a steroid injection directly into the shoulder joint.

If the rotator cuff tendon has been completely torn, surgery may be recommended to repair the tendons in the rotator cuff.

Types of surgery to treat rotator cuff injuries include:

• Arthroscopic tendon repair – minimally invasive orthopedic surgery used to reattach the torn tendon to the bone.
• Open tendon repair – open surgery used to repair the damaged tendon.
• Tendon transfer – a procedure that uses another nearby tendon to replace the torn tendon.
• Shoulder replacement – surgery to completely replace your shoulder. Replacing your shoulder is an invasive treatment reserved for the most severe cases.

When to seek care

Seek care for the shoulder pain that doesn't go away or is deep, acute, or interferes with your daily activities and sleeping. See your doctor right away if you have immediate weakness in your arm after an injury.

Next steps

Your doctor will assess your symptoms and provide treatment accordingly.

Recovery can be a long process. Follow your doctor’s instructions after treatment to ensure a full recovery.

Take steps to prevent a subsequent rotator cuff injury.