Phillips Ambulatory Care Center: 10 Union Square East, Suite 3M, New York, New York 10003
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Rotator Cuff Tears

What is the rotator cuff?

The rotator cuff is comprised of a group of tendons and muscles in the shoulder joint. The purpose of the rotator cuff is to connect the upper arm to the shoulder blade. The shoulder joint is used to rotate the arm in different directions; the rotator cuff helps to achieve that task while providing stability to the joint.

What is a rotator cuff tear?

A rotator cuff tear results from injury to, or weakening of, the tendons that connect the humerus (upper arm bone) to the scapula  (shoulder blade).  The damage to the tendons prevents them from properly attaching to the upper arm bone. A tear to the rotator cuff can prevent the shoulder joint from carrying out daily activities such as getting dressed or lifting groceries. Rotator cuff tears are common shoulder injuries.

The rotator cuff can be torn two different ways: partially or fully. A partial tear does not completely sever the tendon from the bone, but rather damages the tissue. A full-thickness tear, also known as a complete tear, causes the tendon to split into two pieces. When this happens,, the tendon may disconnect from the bone.

What are the symptoms of a rotator cuff tear?

Symptoms of a rotator cuff tear include:

  • Weakness or tenderness in the shoulder
  • Pain when lifting objects or laying on the affected shoulder
  • Crackling sound in the joint
  • Difficulty moving the joint in various directions

Many rotator cuff tears can develop gradually over the time due to wear and tear from every day activities or playing sports. Athletes who play baseball, football, tennis or swim are more prone to this type of injury.

Some tears can be sudden, resulting in a popping sound and intense pain.  Falling on your shoulder or lifting heavy objects may cause such an abrupt tear. If you are experiencing symptoms, it is crucial to see your physician for a physical examination of your shoulder.

How is a rotator cuff tear diagnosed?

Rotator cuff tears cannot be diagnosed with one test alone. If you are experiencing symptoms and have recently suffered traumatic injury to your shoulder, you should make an appointment with your physician. Your physician will perform a physical examination of your shoulder and evaluate the strength, mobility and stability of your joint.

Specific tests such as X-rays or MRIs may be ordered to get a detailed image of the damage. In some cases, however, X-rays or MRIs alone will not show enough detail to make a proper diagnosis and special tests are needed, such as arthrograms. An arthrogram is a test similar an X-ray or MRI in which a special dye is injected into the joint to make more detail visible. Arthroscopic surgery is also a reliable method used to confirm a rotator cuff tear diagnosis. From there, if a tear is detected, it can be corrected with use of arthroscopy.

How is a rotator cuff tear treated?

Many doctors will first recommend noninvasive or nonsurgical methods to help correct a rotator cuff tear. Such methods include rest, reduction of physical activity, and use of anti-inflammatory medications. Physical therapy and strengthening exercises can help to restore function and stability to the shoulder joint. In some cases, steroid injections are recommended if physical therapy and anti-inflammatory medications are not successful.

If nonsurgical methods are not beneficial, your doctor may recommend surgery to correct the tear.  Arthroscopy is a common surgical method used to correct a rotator cuff tear. Anesthesia is administered, commonly in the form of a regional nerve block. A light general anesthetic may also be administered to make you feel more comfortable and relaxed. An arthroscope is used to repair or remove the damaged tissue, as well as restore stability and reattach the damaged tendons to the shoulder joint.

Shoulder replacement is another surgical method that can be recommended to help correct a rotator cuff tear.  This method is used for severe tears that cannot be corrected in any other way. For this surgical method, general anesthesia is used.

Many individuals may be referred to a physical therapy treatment plan after surgery to help restore strength and mobility to their shoulders. The duration of physical therapy will depend mostly on the type of surgery used to correct the tear.

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