The rotator cuff is a combination of four muscles and many tendons that form a covering around the top of the upper arm bone or humerus. These muscles cover the head of the humerus. The rotator cuff holds the humerus in position and allows the arm to rotate. Rotator cuff tear is a very common cause of pain among adults.
Symptoms
This is a common problem affecting people over 40 years of age. A sudden tear may occur due to a single traumatic event or develop progressively because of repetitive overhead actions. A partial tear may result in pain when the arm is lifted in a certain angle away from the body (painful arc syndrome) and a complete tear may prevent the patient from raising the arm. A rotator cuff tear usually takes place in the dominant arm — the right shoulder is affected for right-handed people and the left shoulder for left-handed people.
Signs and symptoms of rotator cuff tears are:
- Constant pain, which keeps coming back, especially with overhead activities.
- Pain during the night that doesn’t allow you to sleep on the affected side.
- Muscle weakness, particularly when you try to lift the arm.
- Catching and grating or cracking sounds when the arm is moved.
- Limited motion.
Causes
- Chronic tear
- Common with people in jobs or sports requiring constant overhead activities (examples: painters, baseball pitchers)
- Variations in the shoulder structure causing narrowing under the outer edge of the collarbone
- Acute tear
- Suddenly raising the arm against resistance, mostly in an attempt to cushion a fall (examples: heavy lifting, a fall on the shoulder)
- Injury most commonly associated with a great amount of force if person is younger than 30 years of age
- Tendonitis
- Degeneration (wearing out) of the muscles due to old age
- Repetitive trauma to the muscle with regular movement of the shoulder
Treatment
Non-Surgical
- The injured shoulder should be rested
- Ice should be applied for a duration of 15-20-minute at least thrice a day for the first two days after the injury.
- Heat should be applied after two days of applying ice. Warmth can be helpful.
- Anti-inflammatory medication is given to reduce the pain and swelling.
- Most rotator cuff tears are treated non-surgically. However, in some patients, surgery may be required as a treatment option. To determine when surgery may be appropriate depends on the type of rotator cuff tear, the activity level of the patient, and the treatments that have been given.
Surgical
There are quite a few surgical options for treatment of a rotator cuff tear. The type of surgery may depend on the factors including the size and location of your tear, and the activities you would want to return to after the surgery. Surgery can be done by both open methods and by Arthroscopic (Minimally invasive) methods.