A rotator cuff tear or rotator cuff injury is a very common ailment affecting the muscles and tendons in the shoulders, with other often reported conditions including bursitis and rotator cuff tendinitis. The rotator cuff is a group of four muscles – the supraspinatus, the teres minor, the subscapularis and the infraspinatus, situated in the shoulders. It performs the primary function of holding the head of the upper arm i.e. the start of the humerus bone, firmly in the shoulder socket. Moreover, the rotator cuff is also crucial in protecting the shoulder joints from minor injuries, severe damage and helps in raising the arms to the level above the head, thereby assisting in easy movement.
A rotator cuff tear occurs when the tendons – the fibrous connective tissues that link muscles to bones in the shoulder area are stretched further away from the upper arm bone i.e. humerus, in turn triggering muscle strain, pain and discomfort. This happens because the shoulder is essentially a ball and socket joint that requires the muscles, bones and tendons to remain within the region of motion. There are two types of rotator cuff tears – partial and complete. In a partial tear, the tendon is torn away only to some extent and a fragment of tissue still remains affixed to the upper arm bone. A complete tear happens when the tendon detaches entirely from the humerus.
Causes Of Rotator Cuff Tear:
Many factors lead to a rotator cuff tear, such as:
- Accidental fall/injury, prompting fracture in the collarbone or dislocated shoulder, like in hip dysplasia that occurs due to dislocation of the hip joint
- Degenerative wear and tear of shoulder muscles due to growing old, particularly above the age of 40, owing to reduced blood circulation to the shoulder joints
- Having a poor posture while sitting and working, like slouching or stretching the body at odd angles and positions
- Overuse of shoulder muscles while working, playing sports or performing any arduous physical activity
- Bone spurs i.e. abnormal growths or lumps in the shoulders resulting in increased friction while moving the arms, similar to calcaneal spur in the heels of the feet
Depending upon the cause of rotator cuff tears, the typical signs comprise substantial pain in the shoulders, muscle weakness due to a sudden injury, or slight discomfort that intensifies with time if ageing is the reason.
Distinct indications of rotator cuff tears consist of:
- Painful sensations in the shoulders while raising the upper arms
- Frequent popping sounds when flexing the arms
- Prominent aching in the shoulder region during rest or prolonged phase of inactivity
- Weakness in the shoulder muscles and tendons hampering the ability to carry out routine physical tasks
- Difficulty in stretching the arms very high up above the head or extending it behind the back
The doctor conducts a thorough physical examination, to assess the ease of movement in the shoulder joints, as well as the range of motion, how strong the arms are and locate any zones of extreme pain, soreness.
Furthermore, diagnostic assays of X-rays, ultrasound and MRI scans are conducted, to obtain detailed images of the rotator cuff muscles, besides the shoulder joints and upper arm bones, which helps spot bone spurs and tendon tears.
The majority of instances of rotator cuff tear only result in minor to moderate pain and damage and can be treated by wearing armrests, taking prescription analgesics, steroid injections to lessen pain and inflammation. In addition, physical therapy and strengthening exercises help in improving the range of motion and restoring the optimal activity of the rotator cuff and shoulder joints.
However, if the patient suffers from a complete tear or non-surgical remedial measures do not subside tenderness and swelling, then the healthcare provider recommends surgery to rectify the rotator cuff tear, which eventually helps regain strength and flexible movement in the upper arms and shoulders.