The 4 Signs of a Torn Rotator Cuff

shoulder pain examination
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Rotator cuff tears are a common cause of shoulder pain, but certainly not the only cause of a painful shoulder. Determining if a rotator cuff tear is the cause of you pain depends on the symptoms and findings of your condition. Your doctor will look for some of the following signs to make the determination if the diagnosis of a rotator cuff tear is the cause of your shoulder pain symptoms.

Pain

Pain from a rotator cuff tear is usually located over the outside of the shoulder and upper arm.

Pain while performing overhead activities (with the arm above head height) and pain at night are also common in individuals with a rotator cuff tear. When the rotator cuff tear is more severe, the pain may awaken patients from sleep.

Decreased Strength

Strength of the rotator cuff tendons can be tested by your doctor. By isolating each of the tendons of the rotator cuff with special tests, your doctor can determine the extent of the tear. Significant rotator cuff tears may affect a patient's ability to raise up their arm over their head. Inability to hold the arm directly out from the body is also a sign of a rotator cuff tear.

Inability to Perform Normal Tasks

Patients with a rotator cuff tear often complain of difficulty performing activities such as combing their hair, clasping a bra behind their back, reaching behind their back, or sleeping on the affected shoulder. Be sure to tell your doctor about specific activities are limited by your shoulder pain.

Abnormal Test Results

If a rotator cuff tear is suspected, a test is usually used to determine if there is a tear. The test most commonly used to diagnose a rotator cuff tear is an MRI, but this is not the only way to diagnose a rotator cuff tear. The MRI is helpful because it can show both complete rotator cuff tears and partial rotator cuff tears.

The MRI can also show evidence of shoulder bursitis and other common shoulder problems. Other tests that may be used to diagnose a rotator cuff tear include an arthrogram and an ultrasound.

I Think I Have a Tear, Now What?

If you think you have a rotator cuff tear, it's time to see your orthopedic surgeon to confirm your suspected diagnosis and to determine a treatment plan.  The good news is, not every rotator cuff tear needs surgery.  However, when surgery is the best treatment, it's often better to proceed sooner rather than later as the rotator cuff muscle can weaken (atrophy) and retract (pull back) over time.  This can make repair less successful or even impossible, therefore it's good to discuss your treatment options with your orthopedic surgeon as soon as possible.

For those patients who choose nonsurgical treatment options, there are a number of ways to find relief of the shoulder pain caused by the rotator cuff tear.  Often with physical therapy and a proper exercise program, patients can improve the function of their shoulder joint to prevent pain that comes from a torn tendon of the rotator cuff.

Sources:

Gartsman, G. "Arthroscopic management of rotator cuff disease" J Am. Acad. Ortho. Surg 1998 Jul-Aug;6(4):259-66.

Iannotti, JP "Full-Thickness Rotator Cuff Tears" J Am. Acad. Ortho. Surg., Mar 1994; 2: 87 - 95.

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