What is the Rotator Cuff?

If you have not yet reviewed the general shoulder anatomy page, please do so now. The rotator cuff is composed of 4 muscles in the shoulder. The tendons of these muscles are one of the reasons that the shoulder is so useful. The tendons can be put under a significant amount of stress, repetitive motion, etc. This repetitive stress and motion tends to weaken the rotator cuff tendons and makes them more subject to injury. The tendons also weaken as we get older, once again making them subject to injury.

How is the Rotator Cuff Injured?

Studies have shown that there are many areas around the rotator cuff tendons that don't receive a significant amount of blood flow. The better the blood supply a tendon has, the better and faster it can repair and maintain itself from everyday wear and tear. Thus, rotator cuff tendons are particularly vulnerable to injury. A rotator cuff tear can be caused by excessive force, such as falling on an outstretched arm, or lifting a heavy object. Tears can also be caused by chronic impingement. It is possible that if a tendon in the rotator cuff is torn, other structures in the shoulder (such as the A.C. joint) could be damaged as well.

What are the symptoms of a Rotator Cuff tear?

Two main problems occur in people with rotator cuff tears. These are pain and weakness. If there is a partial tear in a tendon of the rotator cuff, it's likely that you will be able to move the shoulder normally, but with a significant amount of pain. However,if there is a complete tear of one or more of these tendons, chances are that you will experience pain along with the inability to raise your arm from your side without the assistance of your other arm. A tear of the rotator cuff usually causes a vague pain in the shoulder area and may result in a "catching" sensation when the arm is moved. It's very important to seek an orthopedists care if you have any of these symptoms. If this condition is allowed to go on for too long, recovery could be greatly limited.

How is a Rotator Cuff Tear diagnosed?

A rotator cuff tear is best diagnosed through a physical examination by an orthopedist. A complete tear is usually quite obvious. As stated above, there is usually signficant weakness in the shoulder, and you probably will be unable to lift your arm on your own. If your orthopedist can move your arm in its full range of motion, but you cannot on your own, it's very likely you have a rotator cuff tear.

How is a Rotator Cuff Tear treated?

Rest, Ice and an anti-inflammatory medication will probably be recommended first, in order to reduce pain and inflammation. If a tendon is only partially torn, surgery may not be necessary if the pain becomes tolerable. Physical therapy should be able to help you to regain a good range of motion and significant strength. Surgery will most likely be necessary however, if there is a complete tear of the tendon, or if a partial tear results in more discomfort and weakness than you are willing to tolerate. A complete tear will not heal on it's own. Surgery can be performed with great success in the earlier stages of a rotator cuff tear. Many repair cases are performed via arthroscopy which will help expedite the healing process. In repair, the torn tendon will be reattached to the humerus bone with stitches. You can expect the rotator cuff tendon to heal within 4-6 weeks and to be back to normal in several months. However, it's important to remember that all people are individuals and recovery time will vary.

Other Rotator Cuff associated injuries

A.C. joint separation. If your orthopedist suspects a rotator cuff tear, he will most likely also look at the A.C. joint to make sure it is not injured.