What is a Rotator Cuff Tear?
The rotator cuff refers to a crucial group of tendons and muscles within the shoulder joint, playing a pivotal role in stabilizing and facilitating a broad spectrum of shoulder movements. These tendons — comprising the supraspinatus, infraspinatus, teres minor, and subscapularis — work collaboratively to maintain the shoulder’s integrity and enable smooth motion.
When these tendons sustain significant injury, they can tear, leading to what is known as a rotator cuff tear. This condition is notably prevalent among individuals in their middle-aged and older years, often resulting from repetitive stress, acute trauma, or degenerative changes over time. Such tears can cause considerable shoulder pain, restricting movement and affecting daily activities.
Understanding the symptoms and treatment options for rotator cuff injuries is crucial for effective management. Whether through conservative measures like physical therapy and anti-inflammatory medications or surgical intervention in severe cases, prompt diagnosis and tailored treatment play key roles in restoring shoulder function and alleviating discomfort.
What are the Causes of Rotator Cuff Tears?
The primary causes of rotator cuff tears include:
1. Degenerative Wear and Tear (Chronic Tears)
Most rotator cuff tears occur gradually due to repetitive use and the natural aging process. Over time, the tendons weaken and become more susceptible to injury. Several factors contribute to degenerative rotator cuff tears, including:
- Repetitive Overhead Movements: Individuals who frequently engage in activities that require lifting, reaching, or throwing (such as painters, carpenters, or athletes) are at a higher risk.
- Reduced Blood Supply: As people age, blood flow to the rotator cuff tendons decreases, limiting the body’s ability to repair minor injuries and leading to progressive damage.
- Bone Spurs (Shoulder Impingement Syndrome): Over time, bone overgrowth (spurs) can develop on the acromion, the bone above the rotator cuff. These spurs can irritate or compress the tendons, gradually wearing them down and causing tears.
2. Acute Injury (Traumatic Tears)
Rotator cuff tears can also occur suddenly due to a direct injury. Some common scenarios include:
- Falls – Landing on an outstretched arm or falling directly on the shoulder can cause an immediate tear.
- Heavy Lifting – Lifting a heavy object with improper technique or experiencing a sudden strain while carrying a load can result in a tear.
- Sports Injuries – High-impact sports such as football, wrestling, or baseball (particularly in pitchers) can put excessive stress on the rotator cuff, leading to tears.
3. Poor Posture and Muscle Imbalance
Improper posture, especially when sitting for extended periods with slouched shoulders, can lead to muscular imbalances. Weak shoulder and back muscles fail to properly support the joint, placing additional stress on the rotator cuff and increasing the risk of injury.
4. Genetic Factors
Some studies suggest that rotator cuff tears may have a genetic component, with a higher incidence in families with a history of shoulder problems. This predisposition may make some individuals more susceptible to developing tendon degeneration earlier in life.
What are the Symptoms of Rotator Cuff Tears?
A rotator cuff tear can cause a wide range of symptoms, from mild discomfort to severe pain and functional limitations in the shoulder. The severity of rotator cuff tear symptoms often depends on whether the tear is partial or complete, as well as whether it developed gradually (due to degeneration) or suddenly (due to trauma).
Persistent Shoulder Pain
- One of the most common symptoms of a rotator cuff tear is dull, aching pain in the shoulder.
- Rotator cuff pain is often felt deep within the joint and may extend down the arm, but typically does not radiate past the elbow.
- Discomfort may worsen at night, especially when lying on the affected shoulder.
Weakness in the Shoulder
- Individuals may notice a loss of strength when attempting to lift objects, especially overhead.
- Simple tasks such as reaching for an item on a shelf, combing hair, or getting dressed can become difficult.
Limited Range of Motion
- A torn rotator cuff can make it challenging to move the arm in certain directions, particularly lifting it away from the body.
- Some people may experience stiffness and a sensation of “catching” or locking when moving the shoulder.
Cracking or Popping Sensations (Crepitus)
- A grating, clicking, or popping sensation may occur when moving the shoulder, especially during overhead movements.
- This is often due to the tendons rubbing against surrounding structures in the joint.
Increased Pain with Certain Activities
- Pain often worsens with movements that require raising the arm, lifting objects, or reaching behind the back.
- Athletes or individuals with physically demanding jobs may experience worsening symptoms with repetitive arm use.
Difficulty Sleeping Due to Pain
- Many individuals with rotator cuff tears struggle to sleep because of intense shoulder pain and arm weakness, particularly when lying on the affected side.
- Pain may also increase during the night, making it difficult to find a comfortable sleeping position.
How is a Rotator Cuff Tear Diagnosed?
Your surgeon diagnoses a rotator cuff tear based on a physical examination and X-rays. A rotator cuff tear is best viewed on magnetic resonance imaging (MRI).
What are the Treatment Options for Rotator Cuff Tears?
Conservative treatment
The conservative treatment options for rotator cuff tears are:
- Rest
- Shoulder Sling
- Pain medication
- Injection of a steroid (cortisone) and a local anesthetic in the subacromial space of the affected shoulder to relieve inflammation and pain
- Exercises
Surgery for Rotator Cuff Tears
Rotator cuff repair may be performed by open or arthroscopic surgery. In arthroscopy, the space for rotator cuff tendons will be increased and the cuff tear is repaired using suture anchors. These anchor sutures help in attaching the tendons to the shoulder bone. Following the rotator cuff tear surgery, you may be advised to practice motion and strengthening exercises.
Struggling with Rotator Cuff Pain? Let Us Help You Get Back to What You Love
If you’re experiencing pain, weakness, or limited mobility due to a rotator cuff tear, don’t wait any longer. Our experienced orthopedic team is here to provide personalized care and guide you through every step of your recovery. At Academy Orthopedics, we take the time to understand your unique needs and offer treatment options that are tailored to your goals.
Call us today at 770-271-9857 to schedule your appointment at one of our convenient locations in Cumming, Buford, or Duluth, GA or reach out through our online contact form. We’re here to help you move, live, and enjoy life again—pain-free.
Frequently Asked Questions
When is Surgery Required for a Rotator Cuff Injury?
Surgery is typically necessary for a symptomatic rotator cuff tear that does not improve with non-surgical treatments like physical therapy or medication. It is recommended for large or complete tears, persistent pain and weakness, loss of shoulder mobility, or tears caused by acute injuries. Active individuals or those with physically demanding jobs may also need surgery to restore full function. A doctor will assess the severity of the tear to determine if surgical intervention is the best option.
Is It Safe to Work with a Torn Rotator Cuff?
It depends on the severity of the tear and the type of work you do. For minor tears, rest and avoiding activities that stress the shoulder may help manage symptoms. However, if you have a significant tear, continuing to work—especially in physically demanding jobs—can worsen the injury, cause more pain, and delay healing. It’s best to consult with a doctor to determine a safe course of action.