Rotator Cuff Tear – Causes, Symptoms & Treatment
When you tear the rotator cuff in your shoulder, you've torn the tendon which attaches the muscle to the bone. It sounds nasty - because it usually is. Most tears will occur right in the supraspinatus tendon, but a tear can also happen in other areas of the rotator cuff.
There are two main types of rotator cuff tears:
Partial tears involve damage to the tendon to the point where the tendon becomes thinned out, and torn. With this type of tear, the tendon remains connected to the bone but is at risk of complete separation. The reduced support from the tendon is what results in reduced mobility.
A full-thickness tear happens when the damage to the tendon is so severe that it results in a detachment from the bone. In some cases, only a small part of the tendon is detached from the bone — this is referred to as a full-thickness incomplete tear. A full-thickness complete tear is when there is a hole in the tendon.
How do you know if you’ve torn your rotator cuff?
It’s safe to say that if you’ve torn your rotator cuff, you’ll know about it. However, shoulder injuries are pretty uncomfortable and sore in nature. Here are some distinctive symptoms of a tear:
Pain in the shoulder when pressure is applied (particularly when lying down on the side of the shoulder)
Pain when moving the arm - especially when lifting and lowering
Limited mobility around the shoulder joint, might also be weak
A cracking or popping sensation when moving the shoulder in certain ways
Rotator cuff injuries usually occur while playing sports or conducting a lifting movement. It can also develop over time due to repetitive activities. When the injury occurs, it’s generally accompanied by a sharp pain to the shoulder itself. Some report that it feels like the ligament has snapped. Afterwards, it will be weak and painful to move around.
If it’s an injury that has developed over time, perhaps it won’t be a sudden, sharp sensation but a dull ache that will get worse, particularly after repeating the same movement.
What can cause a torn rotator cuff?
Rotator cuff injuries are either acute or degenerative. You can tear your rotator cuff falling over - falling on an outstretched hand can result in tearing the ligament. However, rotator cuff injuries are usually the result of a sport (baseball, tennis, basketball, golf, swimming) or a job (carpentry, painting, builders, electricians) where you’re repeating the same movement over and over.
Acute rotator cuff injury
Tendons in the rotator cuff are damaged when placed under excessive load in a short span of time, such as when lifting a very heavy object, falling over, or jerking the upper arm. The tissues in the tendon are put under too much strain, and will tear.
Degenerative rotator cuff injury
The majority of rotator cuff injuries are a result of a gradual wearing down of the tendons, eventually resulting in tearing.
Repetitive lifting or overhead actions conducted by the likes of painters or tennis players will face a higher risk of developing a rotator cuff tear. The risk will compound with the degenerative effects of ageing - people over the age of 40 usually face a greater risk.
How is it treated?
A tear can be treated surgically and non-surgically. Treatment will be determined by factors like the extent of the tear and personal health circumstances, which will be taken into account by physiotherapists and GPs when developing a treatment plan.
Research shows that up to 80 to 85% of patients experience significant improvements from the application of non-surgical treatment such as:
Sufficient rest for the affected shoulder - this means stopping the activities that caused the injury
Anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce pain and swelling.
Targeted physiotherapy to progressively strengthen the weak area of the shoulder. Physiotherapists prescribe and help individuals through specially designed exercises and stretches to improve flexibility and range of motion. This is by far one of the most effective forms of treatment for a rotator cuff tear.
In the event of continued pain after a period of non-surgical treatment (and rare cases of major rotator cuff tears), surgical intervention may be necessary to restore part of the tendon.
If you are unsure whether the pain or weakness in your shoulder is a sign of a rotator cuff injury, it's recommended you visit a physiotherapist to obtain an accurate diagnosis. An experienced physiotherapist will be able to pinpoint the root of the issue in your shoulder and prescribe early treatment to prevent it from getting worse.
Infinite Health offers physiotherapy services in North Sydney, Chatswood, Mosman, Hornsby, and the Sydney CBD. Our team of physios are familiar with treating rotator cuff injuries and provides targeted strategies for recovery, pain management, and prevention against future occurrences.
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