Rotator Cuff Tear Causes, Symptoms & Treatment Options

Overview

A rotator cuff injury occurs when one or more of the tendons that make up the rotator cuff become partially or completely detached from their attachment on the humerus, the upper arm bone. These injuries can vary in severity: a partial tear involves damage to only a portion of the tendon, while a full-thickness tear occurs when the tendon is completely torn through.

Rotator cuff tears can result from acute trauma, such as a fall or lifting a heavy object, or from gradual wear and tear over time, especially in individuals who perform repetitive overhead activities, including athletes, laborers, or older adults. The injury often leads to pain, weakness, and limited shoulder mobility.

 

 

What causes Rotator Cuff Tear?

A rotator cuff tear can occur in one of three ways:

• Single traumatic injury: Isolated events, like falling on an outstretched arm while catching a baseball, or lifting too much weight overhead, like in a hang snatch exercise, can result in serious injury to the rotator cuff.
• Overuse: Certain overhead motions of the shoulder, like serving a tennis ball, when repeated over a long period of time, can cause the tendons to slowly wear down, making them susceptible to tearing.
• Age-related: As we age, bone spurs may develop. Sometimes, these growths can lead to impingement of the rotator cuff and eventually tearing, even without much activity.

How the Injury Occurs: Tears happen when the tendon fibers are overstretched or compressed repeatedly, causing fraying, partial tearing, or complete rupture.

Common Everyday Causes: Lifting heavy objects overhead, sudden falls, repetitive arm movements at work, or even carrying heavy bags can gradually damage the rotator cuff.

Rotator cuff tears are common in the following sports:

• Baseball – Repeated throwing motions place high stress on the shoulder tendons.
• Rowing – Continuous pulling and overhead strokes can overload the rotator cuff.
• Tennis – Frequent serving and overhead shots strain the shoulder tendons.
• Weightlifting – Lifting heavy weights, especially overhead, can cause acute or chronic tendon injuries.
• Volleyball – Spiking, serving, and overhead hitting place repeated stress on the rotator cuff.
• Swimming – Repetitive overhead strokes increase the risk of tendon wear and tears.

Symptoms

A tear in one or more rotator cuff tendons can lead to pain and shoulder weakness. You may even inhibit the range of motion. You may have a rotator cuff tear if you experience one or more of the following symptoms:

• Dull ache – Persistent discomfort in the affected shoulder.
• Pain when sleeping – Discomfort increases when lying on the injured shoulder.
• Overhead activity pain – Pain during lifting, throwing, or serving a tennis ball.
• Weakness – Reduced strength in the shoulder and arm.
• Clicking – A popping or clicking sensation when raising the arm.
• Loss of range of motion – Difficulty moving the shoulder fully in all directions.

Non-operative treatment

The goal of non-surgical care is to relieve pain and restore shoulder function. Depending on the severity of the tear, you may try non-operative treatments before considering surgery. If you have a rotator cuff injury, treatment may involve:

• Resting the affected shoulder
• Avoiding any movements that cause pain
• Anti-inflammatory medications, such as ibuprofen, to reduce inflammation and relieve pain
• Physical therapy to strengthen the muscles of the shoulder
• Corticosteroid injections for pain relief (administered to you by your orthopedic specialist)

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Rotator Cuff Tear

Surgical Treatment

Surgical treatment of rotator cuff tears is recommended for all full and partial tears that do not heal with non-surgical treatments. If a partial rotator cuff tear needs surgical treatment, surgery involves removing the damaged part of the tendon and any inflammation to relieve symptoms. For full-thickness rotator cuff tears, surgery aims to reattach the tendon to the humerus. Surgical rotator cuff tear treatment can be performed using one of the following techniques:

• Arthroscopic repair: A minimally invasive surgical technique that uses tiny incisions (roughly one centimeter long) through which special instruments and a camera attached to a thin, flexible tube are inserted. An arthroscopic procedure is typically used to treat partial rotator cuff tears.
• Mini-open repair: A type of hybrid surgery that uses both arthroscopic and open repair techniques. This surgery is performed through one incision measuring approximately three to five centimeters long. The arthroscopic portion of the surgery is performed first. Here, special tools are inserted to assess damage to the rotator cuff and remove any structures, like bone spurs, that may be impeding the rotator cuff muscles. Next, the repair of the torn tendon is performed using a smaller incision to access the tendon manually. Mini-open repair is used to treat full-thickness rotator cuff tears.
• Traditional open repair: A surgical technique that requires one larger incision (greater than five centimeters), which allows your doctor to view the rotator cuff anatomy of the rotator cuff directly.
• Traditional open repair can be used to treat both partial and full rotator cuff tears.

The type of surgery recommended will depend on the size of the tear and the health of the tissue surrounding the tear.