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Rotator Cuff Tear

A rotator cuff tear occurs when one or more of the tendons that make up the rotator cuff become detached from the connecting point of the humerus (arm bone). A rotator cuff tear can be partial (a portion of the tendon is torn, but the tendon is not torn all the way through) or full (the tendon is torn completely through).

Rotator Cuff Tear Hero Image 2

A rotator cuff tear occurs when one or more of the tendons that make up the rotator cuff become detached from the connecting point of the humerus (arm bone). A rotator cuff tear can be partial (a portion of the tendon is torn, but the tendon is not torn all the way through) or full (the tendon is torn completely through).

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.

Rotator cuff tears are common in the following sports:

• Baseball
• Rowing
• Tennis
• Weightlifting
• Volleyball
• Swimming

Symptoms

Typically, a tear in one or more of the rotator cuff tendons will cause pain and may even inhibit range of motion. You may have a rotator cuff tear if you experience one or more of the following symptoms:

• A dull ache in the affected shoulder.
• Pain that worsens when sleeping on the affected shoulder
• Pain when completing overhead motions, like serving a tennis ball
• Weakness in the arm
• Clicking when elevating the shoulder
• Loss of range of motion

When to see a doctor

If you have pain in your shoulder that does not go away or that increasingly gets worse over time, this could be a sign of a rotator cuff tear, and you should make an appointment to see an orthopedic specialist. If you experience loss of motion after an injury or are experiencing extreme pain, see an orthopedic specialist right away.

During your appointment, your doctor will examine your shoulder and will also ask you to describe your symptoms. Your doctor will also do a physical examination where he/she observes your range of motion, as well as the strength of the arm located on the same side as the affected shoulder.

If you have a rotator cuff tear, it is important to determine whether it is partial or complete. In order to make a diagnosis, your doctor may prescribe certain imaging tests, like:

• Ultrasound
• MRI
• X-rays

Non-operative treatment

The goal of rotator cuff tear treatment is to eliminate pain and restore range of motion. Depending on the severity of the tear, you may try non-operative treatments before considering surgery. If you’re experiencing symptoms of a rotator cuff tear, treatment may include:

• 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)

You can also try these exercises at home to stretch and strengthen the muscles surrounding the shoulder:

Rotator Cuff Tear

Surgical Treatment

Surgical treatment of rotator cuff tears is recommended for all full tears 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 in addition to any inflammation in order to relieve symptoms. For full thickness rotator cuff tears, the goal of surgery is to reattach the tendon to the humerus. Surgical repair of a rotator cuff tear can be performed using one of the following techniques:

• Arthroscopic repair: A minimally invasive surgical technique which 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 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.

Recovery

The time it takes to recover from a rotator cuff tear depends on the severity of the tear. If non-surgical treatments are effective, recovery time can take roughly six weeks. If you need surgical treatment, recovery time depends on the size of the tear. Partial rotator cuff repairs may only take three to six months to recover, but complete tears may require six to 12 months to return to overhead sports. Following surgery, you will need to wear your arm in a sling for several weeks to allow the shoulder to heal. When instructed by your doctor, you will start physical therapy to regain range of motion and strength. You should not return to sports until you are pain-free with full range of motion and strength.

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