What Is a Rotator Cuff Tear?

Written by WebMD Editorial Contributors

• What Is a Rotator Cuff Tear?
• Rotator Cuff Tear Symptoms
• Rotator Cuff Tear Causes and Risk Factors
• Rotator Cuff Tear Diagnosis
• Rotator Cuff Tear Complications
• Rotator Cuff Tear Treatment
• Rotator Cuff Tear Outlook
• Rotator Cuff Tear Prevention
• More

A rotator cuff tear is a rip in the group of four muscles and tendons that stabilize your shoulder joint and let you lift and rotate your arms (your rotator cuff). It’s also called a complete tear or a full-thickness tear.

There are two kinds of rotator cuff tears. A partial tear is when one of the muscles that form the rotator cuff is frayed or damaged. The other is a complete tear. That one that goes all the way through the tendon or pulls the tendon off the bone.

It’s a common injury, especially in sports like baseball or tennis, or in jobs like painting or cleaning windows. It usually happens over time from normal wear and tear, or if you repeat the same arm motion over and over. But it also can happen suddenly if you fall on your arm or lift something heavy.

You can’t always feel a torn rotator cuff. But in some cases, you might:

• Have trouble raising your arm
• Feel pain when you move your arm in certain ways or lie on it
• Have weakness in your shoulder
• Be unable to lift things like you normally do
• Hear clicking or popping when you move your arm

See your doctor if you have any of these signs. If you don’t do anything about a torn rotator cuff, you can have more serious problems over time. You can end up with a frozen shoulder or arthritis that is harder to treat.

You can tear your rotator cuff in two ways: injuring your shoulder or wearing down your tendons over time.

A worn down rotator cuff that tears is called a degenerative tear. Your risk of this goes up with:

• Occupation. Jobs like house painters and construction workers put you at a higher chance of rotator cuff tears.
• Lack of blood supply. As you get older, you get less blood to your rotator cuff area, which makes small tears hard to repair, leading to larger tears.
• Bone spurs. Bone overgrowth in the shoulder, which happens more often as you get older, can wear away the rotator cuff tissues and cause tears. 
• Age. Rotator cuff tears are most common in people over 60.
• Family history. Doctors think there could be a genetic piece to rotator cuff tears. They happen more often in certain families.
• Athletics. Baseball, tennis, rowing, and weightlifting are sports that stress your rotator cuff and put you at risk of tears. 

To find out if you have a torn rotator cuff, your doctor will start with a history of the injury and a physical examination of the shoulder. During the exam, they’ll check your range of motion and muscle strength. They’ll also see what movements make your shoulder hurt.

In addition, your doctor may use one of the following:

• MRI, which uses radio waves and a powerful magnet to make detailed pictures of your shoulder.
• X-rays to see if the top of your arm bone (humeral head) is pushing into your rotator cuff space.
• Ultrasound to see the soft tissues (tendons, muscles, and the bursas) in your shoulder.

If you don’t treat your rotator cuff tear, you may experience weakness, or you could lose the ability to move your shoulder permanently. Your shoulder joint may deteriorate too. 

You’ll need to rest your shoulder as you recover, but if you keep it still for too long your connective tissue can thicken up and get tight. This is called frozen shoulder.

Your doctor is likely to start with a combination of several treatments including:

• Physical therapy to make your shoulder muscles stronger
• Medications like acetaminophen and anti-inflammatory drugs to help with pain and swelling
• You also may get exercises to do at home and suggestions that help you use your shoulder in safer, more comfortable ways in your day-to-day life.
• Rest to allow your rotator cuff to heal
• Steroid injections into your shoulder joint, which can provide temporary pain relief

If those don’t work, you may need surgery, especially if you have a complete tear. It’s likely your doctor will need to stitch together the torn area or reattach the tendon to the bone.

In some cases, they might need to take out small pieces of tendon or bone that are stuck in your shoulder joint, or remove small areas of bone or tissue to give your tendon more room to move.

Types of rotator cuff surgery:

• Arthroscopic. Your doctor will make a small cut in your shoulder then use an arthroscope — a tube with a small camera and tiny instruments — to fix the tear. This means your recovery time will likely be shorter than it would with another type of surgery.
• Open. Your doctor uses larger instruments to go into the muscles of your shoulder and fix the tear.
• Mini-open.  This uses both arthroscopic and open methods. Your doctor starts with the arthroscope and finishes with larger instruments.
• Tendon transfer. If your tendon is too torn to reattach, the doctors can use another nearby tendon.
• Shoulder replacement. If the rotator cuff tear is large enough, you may need to have your shoulder joint replaced.

After surgery, you’ll wear a sling for 4-6 weeks. Your doctor probably will tell you to do the following to speed along your recovery:

• Take the sling off several times a day and move your elbow, wrist, and hand to get better blood flow in those areas.
• If you have pain and swelling in your shoulder, use an ice pack for about 20 minutes at a time.
• Most important: Don’t lift your arm at the shoulder until your doctor says it’s OK.

How your recovery goes will depend a lot on the size of the tear and how long your rotator cuff was torn. The smaller and more recent the tear, the better your chances of being pain-free and having a full range of motion.

Be patient. Recovery is a gradual process. It can take up to a year for you to have full use of your shoulder again.

To reduce your risk of a rotator cuff tear, especially if you’re in a high-risk category, you can do exercises to strengthen your shoulders. 

You should focus on both the front muscles of the chest, shoulder, and upper arm, as well as the back of your shoulder. This balances your muscles. Ask your doctor for exercise ideas to help strengthen your shoulder area.

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Rotator Cuff Tear – Causes, Diagnosis, and Treatment

Conservative Treatment Options for Rotator Cuff Tear

• Rest
• Shoulder sling
• Pain medication Injection of a steroid (cortisone) and a Local anesthetic in the subacromial space of the affected shoulder to help decrease the inflammation and pain
• Certain Exercises

Dr. Berkman and his staff see patients with rotator cuff tears at his Houston, Texas clinic, covering the areas including Spring Valley, Bellaire, and more.

Surgery for Rotator Cuff Tear

Rotator cuff repair may be performed by open surgery or arthroscopic procedure. In arthroscopy procedure space for rotator cuff tendons will be increased and the cuff tear is repaired using suture anchors. These anchor sutures help in attaching the tendons to the shoulder bone. Following the surgery, you may be advised to practice motion and strengthening exercises.

Rotator Cuff Pain

Normal Anatomy of the Rotator Cuff

The rotator cuff consists of a group of tendons and muscles that surround and stabilize the shoulder joint. These tendons allow a wide range of movement of the shoulder joint across multiple planes. Irritation or injury to these tendons can result in rotator cuff pain.

Causes of Rotator Cuff Pain

Rotator cuff pain may be caused due to:

• Age-related wear and tear of the rotator cuff tendons in the shoulder
• Repeated overhead arm movements as performed during manual labor
• Sports activities such as pitching during baseball or playing racquet sports
• Trauma such as accidents, direct blows to the shoulder, or falling on the shoulder

Symptoms of Rotator Cuff Pain

The symptoms that often accompany rotator cuff pain include:

• Weakness of the shoulder
• Restricted range of motion

Rotator Cuff Pain Exacerbating Factors

Shoulder pain may be exacerbated by:

• Overhead movements
• Reaching behind the back
• Lifting objects
• Lying on the injured shoulder during sleep

Diagnosis of the Cause of Rotator Cuff Pain

Your doctor will make a diagnosis based on:

• History of symptoms
• Medical history
• Physical exam
• X-rays to identify any bony abnormalities that might be irritating the rotator cuff
• MRIs or ultrasounds, which produce better images of the rotator cuff tendons

Treatment of Rotator Cuff Pain

Initial treatment involves the use of conservative methods such as rest, non-steroidal medications, physical therapy and steroid injections.

If the rotator cuff pain is not resolved by conservative methods, surgery may be required. Read on to learn more about shoulder rotator cuff repair near Bellaire, TX.

The goal of surgery is to

• Remove any bony structures or tissue that may be impinging the rotator cuff tendons during movement and causing pain
• Repair/reattach a torn rotator cuff tendon

This can be done arthroscopically (keyhole surgery) or through open surgery.

Following surgery, your arm will be placed in a sling to allow the shoulder time to heal without any stress being placed on it. Once sufficiently healed, physical therapy rehabilitation may be recommended by your doctor to regain strength and range-of-motion.

If you are looking for Rotator Cuff Surgery and Rotator Cuff Repair Doctors in Bellaire, TX, don’t hesitate to consult with Dr. Berkman and his team.

Prevention of Rotator Cuff Pain

Rotator cuff pain can be prevented by taking the following precautions:

• Perform regular stretching and strengthening exercises for your shoulder.
• Maintain good posture while sitting, standing or walking (avoid hunching).
• Take breaks while performing repetitive overhead activities.
• When lifting objects, keep them close to your body.
• Switch sides often when carrying a heavy bag.
• Don’t sleep on the same side every night.

 Contact us for a Knee & Shoulder Surgeon taking appointments from Houston, Sugar Land, Richmond, Bellaire, TX.

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Our team

* we aim to provide the highest quality care

Bessarab Maxim Sergeevich

• Candidate of Medical Sciences
• Specialist in arthroscopic and minimally invasive joint surgery and foot surgery
• Dr. Bessarab is fluent in all conservative
  and surgical methods for the treatment of sports injuries
• Performs over 500 arthroscopic procedures per year

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Charchyan Artak Mikhailovich

• Traumatologist-orthopedist of the highest category
• PhD
• Head of a department in a large city hospital in Moscow
• A well-known Russian specialist in joint arthroplasty, as well as the treatment of bone fractures using low-traumatic methods
• Dr. Charchyan performs over 400 high-tech surgeries per year

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Krasnov Genrikh Olegovich

• Traumatologist-orthopedist
• Member of the Association of Orthopedic Traumatologists of Russia and the Russian Arthroscopic Society
• Proficient in conservative and surgical treatment of joints
• Orthopedic insole maker, shockwave therapy
• Performs up to 300 arthroscopic procedures per year

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• Traumatologist-orthopedist Bessarab M. S. (Outpatient appointment)
  Traumatologist-orthopedist Bessarab M.S. (Outpatient appointment)
  Moscow, st. Shabolovka, 10, cor. 1

• +7 (495) 66-52-123

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Shoulder rotator arthroscopic suture – Traumatology and Orthopedics Center

Minimally invasive shoulder surgery to repair the shoulder rotators (rotator cuff). The aim of the intervention is to locate the damaged part of the rotator cuff, clean it and fix any torn or damaged tendons.

The most common shoulder surgery in the world is shoulder rotator cuff repair or arthroscopic shoulder rotator suture.

The aim of the operation is to locate the damaged part of the rotator cuff, clean it and fix any torn or damaged tendons. The surgeon uses a variety of techniques to rebuild the tendon from healthy tissue while avoiding overstretching and pulling on the soft tissue.

Anatomy

The rotator cuff is the tissue surrounding the head of the humerus, which is a connection of four muscles (supraspinatus, infraspinatus, teres minor, subscapularis) and their tendons.

The rotator cuff allows the shoulder to perform abductive and rotational movements.

Etiology

A fall on the abducted arm or on the shoulder often injures the tendons of these muscles. In some cases, the tendons are torn or torn from their attachment to the humerus. The consequence of the injury is severe pain in the shoulder and the impossibility (limitation) of lifting the injured limb.

If the injury starts, the situation is aggravated by increased pain and degeneration of the tendons. In extreme cases, there is a clinical picture of the development of osteoarthritis of the shoulder and subluxation of the head of the humerus.

Diagnosis

As always, the initial stage of diagnosis should be an examination by an orthopedic traumatologist. If the rupture of the rotor cuff is complete, the symptoms are pronounced and additional diagnostics are not required (the surgeon will examine the joint and soft tissues directly during the operation, at its first stage). If necessary, radiography of the shoulder joint, CT and MRI diagnostics are prescribed.

Orthopedists of our center make a decision about the need for surgery and choose the most gentle method of treating the disease during a consultation based on diagnostic data.

You can make an appointment with an operating orthopedic traumatologist by calling 8(495)414-20-64 , or by filling out the appointment form on the website.

How the surgery works

Traditional approach, open surgery with a few centimeters long surgical incision. The more modern techniques that we use in our center are arthroscopic access (in case of minor injuries) or mini-open access with fixation with anchors (in case of extensive injuries). The operation is called Arthroscopic suture of the rotators (rotator cuff) of the shoulder.

Arthroscopy is a minimally invasive technique that provides minimal risk, easy tolerability and rapid patient recovery. Through minor punctures, using a microscopic video camera, the operating traumatologist performs all the necessary manipulations.

After visualization of the rupture zone, the doctor sutures the damaged areas of the rotator tendons to the area of ​​their anatomical attachment with special anchor fixators (from 1 to 3, depending on the size of the damage).