The arm is held in the shoulder socket by the rotator cuff. It is comprised of tendons and muscles that work together to help rotate and lift your arm. If enough stress is placed on the rotator cuff, it can tear.
Causes
A rotator cuff tear can be caused by a sudden injury or by wear and tear through the years. For example, lifting something overhead in an awkward motion can lead to a rotator cuff injury.
A tear can also occur due to placing repetitive stress on the tendon, such as when pitching, rowing or performing certain job chores that require frequent overhead arm motions. What happens is the stress on the tendon can cause it to fray. As the damage progresses, the tendon can completely tear. Bone spurs can also develop, which can also lead to a rotator cuff injury.
Symptoms and Natural History
Symptoms of a rotator cuff tear include a deep aching pain in the shoulder. The pain may be present at rest and increase when lifting and lowering the arm. Arm weakness may also occur.
If a tear is due to an acute injury, pain will be intense. If a rotator cuff tear is due to degenerative changes, symptoms may come on slower. A tear can become worse over time leading to increased pain and weakness.
A rotator cuff tear can interfere with normal daily activities. For example, sleeping on the affected shoulder can be very painful. Inadvertently rolling onto the shoulder during sleep is common and can interrupt restful sleep. Simple activities, such as fixing your hair or pulling a shirt over your head can be difficult to do.
Diagnosis
In order to make a diagnosis, your doctor will examine your shoulder and test your range of motion. You will likely be asked to lift your arm in different directions, such as overhead.
An x-ray may be ordered to rule out arthritis, but will not show rotator cuff tears. Usually, an MRI will be needed to show soft tissue injury and help your doctor make a definitive diagnosis.
Self-help Treatments for a Rotator Cuff Tear
Early treatment can prevent a rotator cuff tear from becoming worse. Self-help treatment is a good place to start. Temporarily limiting overhead arm movements allows the rotator cuff time to heal. Decreasing activities that lead to shoulder pain, such as lifting weights, is also recommended. Over the counter pain medications may help treat discomfort, but will not heal the tear.
Standard Clinical Treatments for a Rotator Cuff Tear
In many cases, a mild tear will heal with self-help treatments. But additional clinical treatments may also be needed. Physical therapy to strengthen the shoulder can help prevent worsening symptoms.
Surgery may be needed for more severe tears. The procedure involves reattaching the tendon to the upper arm bone. There are different techniques, which may be used based on your circumstances.
Sources
Hospital for Special Surgery. Rotator Cuff Tears, Injuries and Treatments. https://www.hss.edu/condition-list_rotator-cuff-injuries.asp
Mayo Clinic. Rotator Cuff Tear. http://www.mayoclinic.org/diseases-conditions/rotator-cuff-injury/home/ovc-20126921
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