Rotator cuff is a term which refers to the tendons surrounding the shoulder joint. Rotator cuff tear can result from various reasons such as a shoulder injury or aging.
Rotator cuff comprises a group of four muscles, namely infraspinatus, supraspinatus, subscapularis, and teres minor. There are tendons at the end of rotator cuff muscles, which are attached to humerus, the upper arm bone. These tendons fuse together, surrounding the back, front and top of the shoulder joint like a cuff. It allows the shoulder to function through a wide range of motions due to which one is able to perform a number of tasks with the arms.
About rotator cuff tear
This injury or tear occurs when one of the tendons is injured. It could occur in any size and shape. The common tears are categorized as repetitive use and traumatic injuries. In repetitive use injuries, certain repetitive activities cause damage to the tendons. Wear and tear of tendons could also be a cause of this ailment. People with repetitive injuries would be affected by shoulder bursitis, before developing this tear through the tendons.
Traumatic injuries to the rotator cuff are due to some accidents. In such traumatic situations, the tendons are injured. It leads to an injury or a tear, thus, resulting in a weak and painful shoulder. The affected people are not able to lift or rotate their arm and they experience significant pain associated with shoulder movement.
Causes of rotator cuff tear
A rotator cuff tear is commonly found in the people above the age of 40. Degrading and wearing of the rotator cuff tendons is normal with aging. However, only a few people develop weakness and pain from this condition. A sudden tear results from a single traumatic event. It can gradually develop due to repetitive overhead activities. Some of the common causes of this tear are injury, especially while lifting or carrying a heavy object, overuse of shoulder joint after a period of inactivity, poor blood supply to rotator cuff area (common in increasing age), falling on an outstretched arm, and a gradual weakening of the shoulder tendons, associated with hyperactivity.
Signs and symptoms of rotator cuff tear
A partial tear could cause pain when the arm is lifted up in a certain arc. This is called painful arc syndrome. A complete tear can lead to limited ability to raise the arm. Some signs and symptoms of rotator cuff tear are as follows:
Diagnosis of rotator cuff tear
- Recurrent, constant pain, specifically with overhead activities
- Muscle weakness while attempting to lift the arm
- Pain at night leading to insomnia while sleeping on the affected side
- Limited movement
- Catching and grating or cracking sounds while lifting the arm
- Pain is triggered by a particular activity
- Stiffness in the shoulder
- Pain generally occurs in the dominant arm, right shoulder for the right-handed people and left shoulder for the left-handed people
A diagnosis of rotator cuff tear
is made on the basis of physical examination and some imaging tests. In X-rays, there are some visible signs of tear such as formation of bone spurs and narrowing of the space around the tendons. Some commonly used tests for diagnosis are MRI, arthrogram and ultrasound
Treatment of a rotator cuff tear
There are surgical and non-surgical treatment options which might prove beneficial. The non-surgical options include a combination of medications and various therapies such as physical therapy and cold therapy. Anti-inflammatory medications and painkillers are helpful in controlling the symptoms of this tear. Cortisone injections help limit the acute inflammatory process and allow the affected person to continue exercises and therapy.
If the tear is due to injury and if weakness and pain is not relieved after medications and physiotherapy, surgery may be indicated. There are several surgical options for this treatment. The cuff repair
can be done either arthroscopically or by an open surgery or using a combination of both.