The shoulder is incredibly mobile, but with that mobility comes a price. You use your shoulder for so many activities — reaching overhead, combing your hair, throwing a pitch, swinging a racquet, and pushing a car door shut. Repetitive use of its mobility can lead to overuse injuries, such as a rotator cuff tear.
The rotator cuff caps the shoulder joint and consists of four muscles and tendons. These muscles attach your humerus to the shoulder blade and are instrumental in lifting and rotating the arm. The rotator cuff keeps your upper arm bone stable within your shoulder socket. To help you know when your shoulder pain indicates a potential tear and what to do about the injury, Steven E. Nolan, MD, answers some common questions about rotator cuff injuries.
Usually, a rotator cuff tear shows up as a dull ache. You may notice it’s particularly strong when you sleep and lie on the affected shoulder. Pain while lifting and lowering your arm, such as putting groceries away or painting overhead, are other signs. You may also feel weakness in your arm.
Rotator cuff injuries can occur at any age, but being over the age of 40 puts you at greater risk. Aging diminishes the integrity of the soft tissue.
People who play sports with repetitive shoulder movements, such as archers, tennis players, and pitchers, are also more likely to experience a rotator cuff injury. If you have a job that calls for a lot of repetitive movements, such as a painter or carpenter, you’re also at greater risk. A genetic component may put you at risk; if other people in your family have a torn rotator, you might be more at risk.
Less commonly, trauma can cause a tear — such as falling onto an outstretched arm.
A rotator cuff injury is a tear of the soft tissue. You can experience a partial tear, also known as an incomplete tear. You experience damage to the tendon, but it’s not completely severed. A full-thickness tear, also known as a complete tear, separates the tendon from the bone.
Your treatment options depend on the type of tear and your desired results. In many cases, surgery is not inevitable, and you can restore most function and reduce pain with physical therapy, steroids, and anti-inflammatory medications. These nonsurgical treatments are effective in about 80% of cases.
You may need more involved treatment if you want to restore function to play a sport or your job calls for a lot of shoulder movement. Also, if you don’t find relief from nonsurgical methods, we may recommend surgery.
If your symptoms persist without any resolution for six to 12 months and with significant loss of function in your shoulder, surgery may be your only recourse. A tear that is large, as determined by an MRI, and is surrounded by otherwise healthy tissue, can also make surgery a good option. A large tear is usually one that’s larger than 3 centimeters.
Tears caused by a sudden injury and that is fresh, or recent, usually benefit from surgical repair, too.
If you have pain and weakness at your shoulder, early diagnosis is key. Call our office or book online to have your rotator cuff evaluated so you can start treatment before your symptoms worsen, and repair becomes more complicated.