Rotator Cuff Tears

 

A rotator cuff tear is the source of pain and immobility for millions of adults in the United States annually. Most of the adults suffering from rotator cuff pain turn to their doctor for help in dealing with their pain and discomfort.

Ignoring a torn rotator cuff is not an option, because the injury will weaken your shoulder and make even the most basic activities nearly impossible.

 

Description 

In short, a torn rotator cuff occurs when a tendon in your shoulder is torn and is no longer attached to the head of the humerus. In most cases, tears occur in the supraspinatus tendon, however there are a number of tendons that can be affected.

More often than not, a torn shoulder tendon will be begin by fraying, much like a rope or wire that is subjected to too much friction. Over time, the tendon will wear down to a point where it tears altogether, often coming as a result of attempting to lift a heavy object.

There are two different primary types of rotator cuff tears:

Partial Tear—Sometimes referred to as an incomplete tear, a partial tear damages the tendon but does not see it tear completely

Full-thickness Tear—Sometimes referred to as a complete tear, this type of tear is when your tendon completely separates itself from the bone. If you think of your tendon as a chain, a complete tear would be like a chain missing an entire link.

 

Cause

There are two main causes of rotator cuff tears: injury and degeneration.

Just like there are two different types of rotator cuff tears, there are also two main causes: injury and degeneration.

Acute Tear (Injury)

An acute tear occurs when you attempt to catch yourself from a fall or if you suddenly lift something that is too heavy. The sheer force of these incidents can cause the tendon to tear from bone completely, or simply begin the process of fraying. Other times, this type of tear can happen in the wake of another injury, such as a fractured collarbone.

Degenerative Tear

A degenerative tear is something that, for some people, is unavoidable. That is because it is a tear which occurs naturally over time as a result of normal use of the shoulder. Even though most degenerative tears occur in the shoulder attached to your dominant arm, it can happen to either shoulder. If you have a degenerative tear in one shoulder, the likelihood that you will have one in the other shoulder is very high.

There are a many different contributors to a torn rotator cuff, but the three most common are as a follows:

  • Repetitive stress/use—If you spend many hours executing the same motions over and over again, your shoulder’s muscles and tendons become stressed. These stresses can lead to tears of the rotator cuff. From sports such as baseball and racquet ball, to manual labor jobs and chores, some of the simplest tasks can result in a shoulder tendon tear.
  • Reduced Blood Supply—As we age, the blood supply to the rotator cuff is reduced slowly but surely. This is inevitable, but is also something that can lessen your body’s capacity for repairing injuries and can lead to a tendon tear.
  • Bone Spur—As we age, bone overgrowths known as “bone spurs” can form on the bottom side of an acromion bone. When the arm is moved, these overgrowths rub on tendons and weaken them slowly. As this rubbing continues day in and day out, a tear can ultimately result.

Symptoms

There are many symptoms associated with a rotator cuff tear, but some of the most common include:

  • Pain and discomfort at night, especially when laying on the impacted shoulder
  • Pain and discomfort when moving your arm in different, specific directions (lifting, lowering, pulling, etc.)
  • Reduced strength when lifting or otherwise moving your arm
  • Grating sensation or cracking when moving your arm in specific directions

Most of the tears mentioned above are those that occur over time and as a result of the aging process. Sudden tears that happen from a fall or other injury tend to cause intense pain that can be overwhelming. Almost immediately, the affected shoulder will be significantly weakened and unusable.

Tears that are degenerative also cause pain and weakness, but this pain is typically related to specific movements. In addition, the pain caused by a degenerative injury is often not as severe as pain associated with a sudden, traumatic rotator cuff tear. It is often described as a dull, constant pain. Though the pain may not be severe, it will be present every day and occur after even the most common arm movements. Over-the-counter medications such as ibuprofen and aspirin can help relieve this pain initially.

After some time, these over-the-counter medications may not be as effective and the pain you are experiencing may increase. As the pain increases, your ability to use the affected shoulder and arm will decrease. Even the most common tasks, such as brushing your teeth or putting on a shirt, can become nearly impossible.

Not every rotator cuff tear is painful, though these tears may still bring about weakness in the arm and other symptoms.

 

Treatment Options