Rotator Cuff Tear
The rotator cuff is a group of four muscles and tendons that help stabilize the shoulder. Shoulders get their range of motion from the rotator cuff. Each time you pull an item toward you or lift your arm over your head, you are using your rotator cuff.
How Rotator Cuff Tears Happen:
There are two types of rotator cuff tears - acute tears and degenerative tears.
An acute tear can happen if you fall on your outstretched arm or lift something too heavy with a jerking motion. Acute tears can also happen with shoulder injuries (i.e. broken collarbone or dislocated shoulder). This is a common cause of tears in younger people.
A degenerative tear occurs slowly over time, due to long-term overuse and also naturally occurring as we age. When caused by a degenerative codition the rotator cuff could be damaged for months or years before symptoms start to appear. Rotator cuff tears are more common in the dominant arm and the people most at risk for these injuries include:
An acute tear can happen if you fall on your outstretched arm or lift something too heavy with a jerking motion. Acute tears can also happen with shoulder injuries (i.e. broken collarbone or dislocated shoulder). This is a common cause of tears in younger people.
A degenerative tear occurs slowly over time, due to long-term overuse and also naturally occurring as we age. When caused by a degenerative codition the rotator cuff could be damaged for months or years before symptoms start to appear. Rotator cuff tears are more common in the dominant arm and the people most at risk for these injuries include:
- athletes, particularly tennis players, baseball players, rowers, and wrestlers
- people with jobs that require repetitive lifting, such as painters and carpenters.
- older people - aging lessens the bloody supply to the rotator cuff tendons, limiting the body’s ability to repair tendon damage and potentially leading to tears.
Rotator cuff tears may be partial or full thickness tears. When one or more of the rotator cuff tendons are torn, the tendon no longer fully attaches to the head of the humerus. Most often, torn tendons begin by fraying, usually through injury or degeneration. As the damage progresses, the tendon can completely tear, sometimes when lifting a heavy object.
Symptoms:
- Pain at rest and at night, especially when lying on the affected shoulder.
- Pain when lifting or lowering your arm with specific movements.
- Weakness when lifting and lowering your arm.
- Crackling sensation when moving your shoulder in certain positions.
- If caused suddenly, as in a fall or other traumatic injury, there is typically intense pain. There may also be a snapping sensation and immediate weakness in the upper arm.
Treatment:
You should avoid doing anything that aggravates the pain. This may mean that you have to modify or change your work activities. However, do not completely rest your shoulder. Strengthen your shoulder but don't try to work or play through the pain.
With proper care a minor injury often heals on its own, If you think you've injured your rotator cuff, try these steps:
- Apply ice and heat. Putting ice on your shoulder helps reduce inflammation and pain. Use a cold pack for 15 to 20 minutes every three or four hours. After a few days, when the pain and inflammation have improved, hot packs or a heating pad may help relax tightened and sore muscles.
- Take pain relievers. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can be helpful to ease inflammation.
- Exercise. It is really important to keep your shoulder strong and mobile. Your physiotherapist can advise you on an appropriate exercise programme to do at home if the symptoms aren't settling quickly.
Physiotherapy:
Most rotator cuff tears are degenerative or non-traumatic and can be successfully treated by a combination of physiotherapy, prescribed exercises, support sleeves or braces, a shoulder pillow in bed, painkillers and occasionally steroid injections.
Though your rotator cuff may be torn it does not mean that you need surgery. Research has shown that if you have a degenerative tear of your rotator cuff, and did not suffer a significant injury, then it is safe and prudent to consider physical therapy as your primary treatment.
At NorthWest Physio + we will help you to manage the symptoms of your rotator cuff tear as well as improve how your shoulder works. For large rotator cuff tears that can't be fully repaired we can teach special strategies to improve shoulder movement.
Though your rotator cuff may be torn it does not mean that you need surgery. Research has shown that if you have a degenerative tear of your rotator cuff, and did not suffer a significant injury, then it is safe and prudent to consider physical therapy as your primary treatment.
At NorthWest Physio + we will help you to manage the symptoms of your rotator cuff tear as well as improve how your shoulder works. For large rotator cuff tears that can't be fully repaired we can teach special strategies to improve shoulder movement.
Surgery:
For people who have an acute or traumatic tear following a significant injury or fall, surgery may be recommended .
If you decide to have surgery, your physiotherapist can help you both before and after the procedure. (Read more about pre and post operative physiotherapy).
If you decide to have surgery, your physiotherapist can help you both before and after the procedure. (Read more about pre and post operative physiotherapy).
Post-operatively we will work with you to restore your range of motion, muscle strength, and coordination, so that you can return to your regular activities. If necessary we can help you learn to modify your physical activity so that you put less stress on your shoulder.
Can this Injury or Condition be Prevented?
A physiotherapist can help you decrease your risk of developing or worsening a rotator cuff tear, especially if you seek assistance at the first sign of shoulder pain or discomfort.
For more information on rotator cuff tears take a look at ACC's informative brochure, posted on our Blog page.
Call us today at NorthWest Physio + on 09 412 2945, request an appointment via our contact page or make an appointment via our online booking service.