Torn Rotator Cuff Medical Diagnosis and Prevention

Diagnosis, Treatment and Prevention of a Torn Rotator Cuff

high angle view of a young woman holding her shoulder in pain
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A torn rotator cuff is a very common injury - as many as two million people per year seek medical help for it in the United States alone. What is the rotator cuff, what causes this injury and how is it treated?

Rotator Cuff Tears

The rotator cuff is a term used to describe the tendons and muscles in the shoulder that support, stabilize and allow the arm to move up and down, as well as rotate. The rotator cuff is what keeps your arm in your shoulder socket.

The four muscles of the rotator cuff include the supraspinatus, infraspinatus, subscapularis, and teres minor. Each attaches by a tendon to the bones that make up the shoulder - the humerus, scapula and clavicle. 

Injuries and inflammation to these tendons can cause pain and decreased range of motion. You need your rotator cuff for many activities of daily life, including getting dressed. A torn rotator cuff can severely limit movement and strength in the shoulder joint.

In a partial rotator cuff tear, the tendon is torn or frayed. In a full-thickness tear, the tendon is split in two and may be detached from the bone.

Tears can be acute, happening suddenly in a fall or while lifting something. But they can also develop slowly over time with repetitive stress, bone spurs, and age-related degeneration.

Torn Rotator Cuff Symptoms

A common symptom of a rotator cuff injury is aching, and weakness in the shoulder when the arm is lifted overhead.

It may also ache at night, especially when you are lying on that shoulder. You may hear crackling sounds at times when moving the shoulder.

A less severe injury may result in swelling, bleeding and bruising. This creates pain and inflammation as the swollen muscle pushes on the nearby bone. This can last several months before the muscle is entirely healed.

Continued activity can increase the swelling, and lengthen the recovery time.

A torn rotator cuff is much more severe and more serious. The symptoms include pain, decreased range of motion, weakness and a deep ache. These symptoms are often worse at night or in the morning.

A tear needs to be seen and evaluated by a physician to determine if surgery is needed to repair the tendon or to get you on the road to recovery with nonsurgical treatment. Your doctor will perform a physical exam, range of motion and strength tests. You may need an x-ray, MRI or ultrasound to confirm the diagnosis.

Torn Rotator Cuff Treatment

Nonsurgical treatment is often tried first as it works well about half of the time. This includes rest, activity modification, nonsteroidal anti-inflammatory medication and strengthening exercises and physical therapy. Cortisone injection may be used if these do not relieve your pain.

Your doctor may recommend surgical treatment if the other methods do not relieve your pain, and also if you need improvement of strength and return to activity (such as sports). Surgical repair of a torn rotator cuff muscle can often be done with arthroscopic techniques, which use a very small incision, and the patient can go home the same day.

Recovery involves medication to reduce inflammation, and physical therapy exercises to increase range of motion and strength.

The most important part about treating a sore shoulder is to get the right diagnosis. The treatment of a strain is different that a tear, so see your physician if you have an injury to the shoulder that results in pain.

Torn Rotator Cuff Prevention

Stretching and strengthening the shoulder can help prevent injuries, and should be a part of a warm up and general conditioning program.

Shoulder Injury List


April D. Armstrong, Rotator Cuff Tears, OrthoInfo, American Academy of Orthopaedic Surgeons, May, 2011.

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