Overview – Patients who have a rotator cuff tear are likely to have a history of a trauma such as heavy lifting or a fall on outstretched arm. Alternatively, smaller repetitive injuries that are often habitual can be hard to identify because symptoms are more gradual. Patients usually complain of sharp pain/weakness with lifting overhead or behind the back.
The rotator cuff is comprised of 4 muslces: supraspinatus, infraspinatus, subscapularis, teres minor. It is responsible for externally rotating and lifting your arm.
Symptoms – The patient usually has trouble lifting and lowering the injured arm. Sharp pain is present with activity; however, it often diminishes when resting. Sleep can be disturbed by a dull ache or throbbing.
Cause – There are three main causes of rotator cuff tear:
Traumatic Injury – This occurs during a fall, sporting event, lifting, etc and the muscles are overloaded to the point where they fail.
Repetitive – This is the result of habitual activities such as work/poor ergonomics that slowly fatigue/strain the muscles over time to the point where they eventually tear. This can be frustrating as the cause is not always obvious.
Degenerative – Aging, atrophy, arthritis,etc can lead to muscle tearing as the tissues loose strength and integrity. People over the age of 40 are at greater risk for this type of tear.
Treatment options – Rest, ultrasound therapy, therapeutic exercise and stretches, ergonomic advice, medication, surgery, corticosteroid injection
