What is Rotator Cuff Tear in Shoulder?

Rotator cuff is comprised of 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 we are able to perform a number of tasks with our arms.

What is Rotator Cuff Tear?

Rotator cuff tear occurs when one of the tendons is injured. The tear can occur in many sizes and shapes. The common rotator cuff tears are categorized as repetitive use and traumatic injuries. In repetitive use injuries, certain repetitive activities cause damage to the rotator cuff tendons. Wear and tear of tendons could also be a cause of rotator cuff tear. Patients with repetitive injuries complain of shoulder bursitis before developing rotator cuff tear through the tendons.

Traumatic injuries to the rotator cuff are due to some accidents. In such traumatic situations, the rotator cuff tendons are injured. It leads to rotator cuff tear, resulting in a weak, painful shoulder. People with rotator cuff tear are not able to lift or rotate their arm and they experience significant pain associated with shoulder movement.

Causes of Rotator Cuff Tear

This problem is commonly found in the people above the age of 40. Degrading and wearing of 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 rotator cuff 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 outstretched arm and a gradual weakening of the shoulder tendons, associated with hyperactivity.

Signs and Symptoms of Rotator Cuff Tear

A partial tear of rotator cuff can cause pain when the arm is lifted up in a certain arc. It is called as 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:

• 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

Diagnosis of Rotator Cuff Tear

Diagnosis of rotator cuff tear is made on the basis of physical examination and some imaging tests. In Xrays, there are some visible signs of tear such as formation of bone spurs and narrowing of the space around the rotator cuff tendons. Some commonly used tests to diagnose the rotator cuff tear are MRI, arthrogram and ultrasound.

Treatment for Rotator Cuff Tear

There are surgical and non-surgical treatment options for the treatment of rotator cuff tear. 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 rotator cuff tear. Cortisone injections help limit the acute inflammatory process and allow the patient 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 to treat the rotator cuff tear. The cuff repair can be done either arthroscopically or by an open surgery or using a combination of both.