Rotator Cuff Tear


 

A tear in the muscles that attach to the upper arm at the shoulder joint. These muscles are involved in shoulder and arm motion, and may tear off of the bone, or in the substance of the muscle itself.

 

Common Causes

Lifting heavy objects, overhead use of the arm, a fall on the outstretched arm or other trauma.

 

Symptoms

Pain in the shoulder, often radiating down the side of the arm or up to the neck. Pain is worsened with using the arm overhead, lifting objects, or sleeping on the injured side. Patients often report weakness in the arm and shoulder, with stiffness, or loss of motion.

 

Physical Findings

Tenderness over the rotator cuff, weakness, pain with 'impingement test.'

 

Workup

Physical examination, X-rays, possibly an MRI scan.

 

Non-operative Treatment

Physical therapy and anti-inflammatory medication, avoidance of aggravating activities.

 

Surgical Treatment

Arthroscopy, with arthroscopic or open rotator cuff repair.

 

Injury Comment

Rotator cuff tears generally do not heal on their own (the tendon retracts when torn, like a rubber band, and the torn edges are not adjacent to each other). Many rotator cuff tears can now be repaired arthroscopically, without a large incision. Following a rotator cuff repair, protection of the shoulder is usually required for several weeks, and full recovery may take many months.