A rotator cuff tear is an injury to the group of muscles and tendons that stabilize the shoulder joint and allow for overhead arm movement.

The rotator cuff is a group of four muscles and tendons that form a “cuff” over the shoulder joint, holding the upper arm bone in the shoulder socket and enabling overhead arm movements. A rotator cuff tear is a partial or complete tear in one or more of these tendons.

Common Symptoms

• Pain at rest and at night, especially when lying on the affected shoulder
• Pain when lifting or lowering the arm
• Weakness when lifting or rotating the arm
• Crackling sensation when moving the shoulder

Cause & Anatomy

Causes of Rotator Cuff Tears:

• Acute injury from a fall or traumatic event that tears the tendon
• Degenerative wear and tear over time due to aging, overuse, lack of blood supply
• Tears are more common in the dominant arm and with increasing age.

The four rotator cuff muscles are the supraspinatus, infraspinatus, subscapularis, and teres minor. Their tendons form the “cuff” over the head of the humerus (upper arm bone).

Diagnosis

• Physical exam testing arm movements and strength
• X-rays to check for bone spurs
• MRI to visualize the soft tissues and determine if there is a partial or full tear

Prevention

Avoiding overuse injuries through proper technique in sports/jobs involving overhead arm movements. Avoiding heavy overhead lifting and pull ups. Strengthening the rotator cuff muscles.

Treatment

• Early treatment is important to prevent further damage and larger tears
• Rest, activity modification, anti-inflammatory medication for mild tears
• Physical therapy to improve strength and range of motion
• Steroid injections to reduce inflammation
• Surgery for severe, acute tears or tears that don’t respond to non-surgical treatment

Surgery

The torn tendon is reattached to the bone, often using sutures or anchors. Surgery aims to restore function and relieve pain.

Rehabilitation

Rehabilitation plays a vital role in regaining strength and mobility after a rotator cuff tear, both with and without surgery. A structured physical therapy program is critical, including:

• Initial rest and protection of the repair
• Gradual range of motion exercises
• Progressive strengthening exercises
• Full recovery may take 6 months to a year.