Rotator Cuff Tears

A Guide to Treatment of a Torn Rotator Cuff

Rotator cuff tears are a common injury of the complex shoulder joint. Because of our dependence on the shoulder for many activities, rotator cuff injuries can be frustrating experiences. Learn more about rotator cuff tears, including diagnosis, symptoms, treatments and rehabilitation.

Causes of Shoulder Pain

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Shoulder pain is an extremely common complaint that has many causes. Because we use our arms for so many common activities, shoulder pain can cause significant problems. In order for proper treatment, the cause of the problem must be identified.

Many people with shoulder pain may be told by a friend or family member that their symptoms sound like their rotator cuff problem. However, there are other causes of shoulder pain, and without an accurate diagnosis the treatment may not properly target the actual problem. Before beginning any treatment plan, be sure you understand the source of your pain.

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What Is the Rotator Cuff?

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The rotator cuff is the group of four tendons and muscles that surround the shoulder joint. Often confused with other names, the proper word used to describe these muscles and tendons is the rotator cuff. When the rotator cuff is injured, it's the tendons of the rotator cuff that are injured. It is these tendons that connect the rotator cuff muscles to the bone. When the tendons are inflamed or torn, they cannot function properly.

The rotator cuff is not only important with lifting movements of the shoulder, but the muscles and tendons are critical to the normal stability and mechanics of the shoulder. Without a properly functioning rotator cuff, you would expect some limits in normal shoulder function.

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Rotator Cuff Tear Symptoms

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The most common symptom of a rotator cuff problem is pain. Patients usually complain of pain over the top of the shoulder and arm. In some patients, the pain can descend down the outside of the arm all the way to the elbow.

The other common symptom of a rotator cuff tear is weakness of the shoulder. Weakness causes difficulty lifting the arm up overhead or difficulty with activities such as reaching, getting dressed, or carrying objects.

Rotator cuff tears are incredibly common, especially as we age. So common, that most people with a torn rotator cuff don't even realize they have a problem. Most people with a rotator cuff tear have no pain and minimal limitations in function. However, sometime the tear can cause symptoms, and these individuals may require treatment.

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Rotator Cuff Tear Treatments

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Most rotator cuff tears can be treated without surgery -- in fact, it is the small minority of patients who end up undergoing surgical treatment for a rotator cuff tear.

Non-operative rotator cuff treatments may include physical therapy, anti-inflammatory pain medications, and cortisone injections. The goal of treatment is to reduce inflammation and strengthen the uninjured muscles around the shoulder to compensate for the torn muscles.

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Is Surgery Necessary for a Rotator Cuff Tear?

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Most rotator cuff tears can be treated non-surgically. However, in some patients, surgery may be recommended as a treatment option. Surgery is performed to repair the torn tendons. Determining when surgery may be appropriate depends on the type of rotator cuff tear, the patient's activity level, and the treatments that have been attempted.

While surgery is often the best treatment to attempt to restore normal function the the shoulder, there are some reasons people may opt to not have surgery. First, most people do not require full function to do all the activities they want to do. Many people can do sports, housework, and their jobs, with rotator cuff tears. Second, the rehab after surgery can be long and difficult. Many patients have symptoms for 6 months to a year following surgery.

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Rotator Cuff Tear Surgery

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There are several surgical options for treatment of a rotator cuff tear. The exact type of surgery may depend on factors including the size and location of your tear, your surgeon's preference, and the activities you want to be able to return to after surgery. Discuss with your doctor which type of surgery he or she may be recommending for treatment of your rotator cuff tear.

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Rehab After Surgery

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Healing from surgery for a rotator cuff tear is entirely dependent on a patient being able to perform proper rehabilitation and avoid activities that may injure the healing tendons. Rehab after rotator cuff surgery can vary widely, but there are some general principles that are true for most patient having surgery for treatment of a rotator cuff tear.

As mentioned earlier, rehab following rotator cuff surgery can be long and difficult. Many patients take a year to get back to normal. Some less-invasive surgical procedures can speed recovery, and make rehab less painful, but be prepared for a recovery that may be longer than your would want. The good news is, the vast number of patients are back to full activities within several months, and most return to their normal activities.

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