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Rotator Cuff Tears

What is a Rotator Cuff Tear?

Your rotator cuff is one of 4 muscles that hold your arm to your shoulder. The rotator cuff attaches your upper arm to the shoulder blade. It also allows you to lift and rotate your arm.

Another of the parts that enable you to move your arm is the bursa. If the rotator cuff becomes damaged, the bursa under the cuff can also become inflamed and quite painful.

There are two versions of rotator cuff tears. The partial rotator cuff tear may also be called an incomplete tear of the cuff. The tendon is damaged in an incomplete rotator cuff tear, but it is not completely severed.

The other version of rotator cuff tear is the full –thickness tear, which is also called a complete tear. The tendon is severed from the bone, and there is usually a hole at the base of the tendon.

What are the causes of rotator cuff tears?

Acute Rotator Cuff Tear

If you fall and damage your rotator cuff, this is an acute rotator cuff tear. If you should happen to lift something heavy suddenly or fall on an outstretched arm, you may tear your rotator cuff. Acute rotator cuff tears can also occur with other types of shoulder injuries, like broken collarbones and shoulder injuries.

Degenerative Rotator Cuff Tears

A degenerative cuff tear comes about through a tendon that wears out over time. Also, if one shoulder contains a degenerative rotator cuff tear, the other shoulder may also have a degenerative tear, even if it doesn’t hurt.

What are some of the causes of a degenerative rotator cuff tear?

Some of the causes of a degenerative rotator cuff tear are:

  • Repetitive stress, which means that the rotator cuff is frequently used in a repetitive motion.
  • Lack of blood supply to the rotator cuff causes an inability for the body to repair tendon damage when it occurs. This lack of healing ability can lead to a tear in the tendon.
  • Bone spurs. Bone overgrowth in the acromion area of the shoulder causes bone spurs. When bone spurs rub against the rotator cuff, the bone spur wears out the tendon.

How Common are Rotator Cuff Tears?

Rotator cuff tears are fairly common in jobs requiring repetitive motions (http://www.webmd.com/fitness-exercise/guide/rotator-cuff-tear#1). They also tend to occur as a natural part of aging.

What are common sports played that result in rotator cuff tears?

Several sports use the shoulder repeatedly and may cause the rotator cuff to wear out with time. Some examples of sports that may cause the rotator cuff to wear include any sport that uses the shoulder routinely. Rowing, sports that require throwing, bowling, cricket and pitching baseball are frequent sports that are related to rotator cuff tears.

What are the symptoms of a rotator cuff tear?

The most common symptoms of a rotator cuff tear include:

  • Pain during rest and when lying on the damaged shoulder at night.
  • Pain when raising and lowering your arm, or during moving your arm in specific ways.
  • Increased weakness when using your arm, especially when performing lifting and rotating motions with your arm.
  • Crackling and popping sound when you move your shoulder (Crepitus).

Some tears are not painful but have such symptoms as weakness and difficulty moving the shoulder.

How is a rotator cuff tear diagnosed?

Make an appointment with your orthopedic specialist. Your doctor will examine the shoulder in question by checking it for pain and deformity. Your physician will also check the range of motion on that shoulder and your arm’s strength.

Imaging tests are used such as x-rays, ultrasounds, and MRIs to determine whether or not a rotator cuff has occurred. X-rays are used to determine whether a bone spur is present that may be causing the cuff tear. Ultrasounds and MRIs may be used to view the actual soft tissue of the rotator cuff tendon, and thereby show the physician if there is a tear, and how severe the damage is if it is found.

What are the Complications of a Rotator Cuff Injury?

Complications of a rotator cuff injury are increasing pain and inflammation. The person may not be able to rotate their shoulder.

How is a Rotator Cuff Tear Treated?

A rotator cuff tear may be treated non-surgically before surgery is considered. In fact, about 80 percent of patients treated for this disorder improve nicely when non-surgical methods are used.

Non-surgical treatment may include:

  • Rest, a sling and not using the arm extensively.
  • Modifying activities.
  • NSAIDS and other anti-inflammatory medications to reduce swelling and pain.
  • Physical therapy and arm strengthening.
  • Range of motion exercises.
  • Steroidal injections.

Unfortunately, in some cases, a small rotator cuff tear only gets worse instead of better. When that situation occurs, it is time to consider rotator cuff surgery.

  • Repetitive stress, which means that the rotator cuff is frequently used in a repetitive motion.
  • Lack of blood supply to the rotator cuff causes an inability for the body to repair tendon damage when it occurs. This lack of healing ability can lead to a tear in the tendon.
  • Bone spurs. Bone overgrowth in the acromion area of the shoulder causes bone spurs. When bone spurs rub against the rotator cuff, the bone spur wears out the tendon.

Unfortunately, in some cases, a small rotator cuff tear only gets worse instead of better. When that situation occurs, it is time to consider rotator cuff surgery.

Surgical Treatment

Your doctor may suggest surgery if your pain levels do not improve using nonsurgical methods. If you are very active and use your arms for overhead work or sports, your doctor may recommend surgery.

What are the expected recovery outcomes of a rotator cuff surgery?

Expected recovery outcomes for rotator cuff surgery include a reduction or elimination of pain plus recovered strength and amount of motion the arm can perform.

If left untreated, what is the prognosis for an untreated rotator cuff tear?

Untreated rotator cuff tears may heal without surgery. Unfortunately, in many cases, rotator cuff tears need physical therapy, surgery or both to completely heal.

Contact West Idaho Orthopedics

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