Rotator cuff injuries are often associated with athletes – a star pitcher or quarterback makes headlines because they are scheduled for surgery to repair a tear in their shoulder.
But more often than not, torn rotator cuffs affect carpenters, construction workers, painters, and people in their 40s and older who have worked at jobs where they lift heavy objects and make repetitive overhead arm movements over a long period of time. Many patients delay care because they don’t want to have surgery. But not every patient needs surgery to repair a torn rotator cuff. Currently, the best approach for torn rotator cuff treatment is a close evaluation of your injury, daily activities, and goals. Using this information, we can personalize the most effective, least invasive path to long-term pain management and improved shoulder function.
CAUSES:
There are two main reasons why the rotator cuff can tear:
- Trauma This could be due to falling down on an outstretched arm, breaking a collarbone, dislocating a shoulder, or lifting a heavy object recklessly. Typically, these are singular incidents.
- Overuse The tendons that compose the rotator cuff wear down over time. Repetitive movements (pushing a paint roller up and down or across a ceiling, pitching a baseball over and over, washing windows) can take their toll on this part of the body.
As we age, blood doesn’t circulate to our joints as well, leaving them less prepared to manage damage. Minor insults to the shoulder aren’t as quickly repaired by our natural immune system responses—which include inflammation—so the chances of small tears become major injuries increases.
Another problem occurs when we age. Bone overgrowth on the underside of the acromion bone, called spurs, can rub against rotator cuff tendons, creating a condition for tearing called shoulder impingement.
SYMPTOMS:
- Weakness in the shoulder when you try to lift your arm or rotate it
- Pain in the shoulder at rest, especially while lying down on it
- Pain while trying to use the shoulder to lift or lower the arms
- A crackling sensation that occurs when trying to move the shoulder in a certain way (crepitus).
Pain can be mild or severe, dull or bright. It can be relieved by over-the-counter pain relievers if there’s a gap in time between the injury and your opportunity to see a doctor. You might feel a snapping sensation immediately after the tear occurs. As time passes, simple tasks like combing your hair may become nearly impossible. These are all signs you need to seek medical attention for your injury.
DIAGNOSIS:
The doctor conducts a thorough physical examination, to assess the ease of movement in the shoulder joints, as well as the range of motion, how strong the arms are and locate any zones of extreme pain, soreness.
Furthermore, diagnostic assays of X-rays, ultrasound and MRI scans are conducted, to obtain detailed images of the rotator cuff muscles, besides the shoulder joints and upper arm bones, which helps spot bone spurs and tendon tears.
TREATMENT:
The majority of instances of rotator cuff tear only result in minor to moderate pain and damage and can be treated by wearing armrests, taking prescription analgesics, steroid injections to lessen pain and inflammation. In addition, physical therapy and strengthening exercises help in improving the range of motion and restoring the optimal activity of the rotator cuff and shoulder joints.
However, if the patient suffers from a complete tear or non-surgical remedial measures do not subside tenderness and swelling, then the healthcare provider recommends surgery to rectify the rotator cuff tear, which eventually helps regain strength and flexible movement in the upper arms and shoulders.