What Is Rotator Cuff Tear?

The rotator cuff is a combination of muscles and tendons that link your upper arm bone, the humerus, to your shoulder blades. The rotator cuff also holds your upper arm bone in place in your shoulder socket. The four muscles of the rotator cuff are the supraspinatus, the infraspinatus, the teres minor and the subscapularis. Each muscle is connected to the arm bone by a tendon. Rotator cuff repair is the surgery used to repair a tear in one of these tendons.

Symptoms of Rotator Cuff Injuries

People of all ages injure their rotator cuffs. Some are good candidates for surgery, while others will pursue different treatments.

You can injure your rotator cuff through wear and tear or poor movement patterns over time. Slouching and chronically pushing your head forward are two movement patterns that put your rotator cuffs at risk. As you get older, the rotator cuff can be irritated or pinched by calcium deposits in your shoulder area or bone spurs due to arthritis.

Repetitive stress is another culprit. Tennis players, swimmers, and baseball pitchers are at risk for repetitive stress injuries of the shoulder, as are carpenters and painters.

Rotator cuff injuries vary. Your tendons may be inflamed from overuse, or partially or fully torn. You may also feel pain in your shoulder from bursitis. This is a condition in which the bursa, a sac filled with fluid that sits between your rotator cuff and your shoulder joint, becomes inflamed and irritated.

Symptoms of a rotator cuff injury include:

• shoulder weakness
• not wanting to move your shoulder
• shoulder pain, especially when you lift, pull, and reach behind your back or overhead
• decreased range of motion in your shoulder joint

Diagnosing Rotator Cuff Injuries

A medical history and a physical exam are extremely important for proper diagnosis of rotator cuff injuries. You will need to get a complete medical history. This is the time to tell your doctor about your activity and exercise history. Your doctor will also perform a physical exam. During the exam they will do a series of maneuvers to help determine the cause of the pain you’re experiencing.

Your doctor will then order certain tests to confirm the diagnosis. These could include shoulder X-rays, MRI, or an ultrasound. An MRI uses radio waves and magnetic fields to take pictures of the structures and organs inside your body. An ultrasound uses sound waves to form pictures of your insides. These tests all give slightly different views of the internal structure of your shoulder.

Based on the exam findings and results of the imaging tests, your doctor will decide whether or not rotator cuff repair surgery is your best treatment option. If surgery is being considered, your surgeon may want to examine your shoulder further by using an arthroscope. However, this is not always done. During an arthroscopy, a small camera will be used to investigate your rotator cuff. During this procedure, you’ll first receive a numbing agent for your shoulder. Then, your doctor will poke a small hole in your shoulder and insert the camera, which is linked to a video monitor. Your surgeon will use this camera to look at your tendons, ligaments, and cartilage to determine whether surgery may help to solve your shoulder problems.

Deciding on Rotator Cuff Repair Surgery

Surgery isn’t often the first recommended treatment for shoulder injuries. Your doctor may first recommend rest, ice packs, and special exercises. If the injury isn’t severe, these treatment approaches may be enough. If a tendon is torn, rest and exercise may decrease the pain, but won’t repair the tear. Surgery may be needed.

Your doctor will suggest that you discuss surgery with an orthopedic surgeon if you:

• have shoulder pain that lasts for more than six months, even after physical therapy
• have shoulder weakness that interferes with everyday activities
• are an athlete
• use your shoulders and arms for your work

Rotator cuff repair surgery works best on recent injuries rather than those caused by chronic conditions. See your doctor as soon as possible after an injury has occurred.

Preparing for Rotator Cuff Surgery Repair

Resting and applying cold packs are good ways to ease your shoulder pain while you wait for surgery. Your doctor or physical therapist may also recommend certain exercises to help with pain.

You may want to take over-the-counter drugs, such as aspirin, ibuprofen, and naproxen. These are anti-inflammatories as well as painkillers. Make sure your doctor knows exactly what medications and supplements you’re taking, as some may need to be discontinued before surgery.