Reviewed by Sports Medicine Physician Dr. G. Lane Naugher G. Lane Naugher, MD | Sports Medicine Surgeon in San Antonio
What is a Rotator Cuff Tear?
Shoulder pain can disrupt every aspect of your life, from simple tasks like lifting bags of groceries to enjoying your favorite hobbies. One of the most common causes of persistent shoulder pain is a rotator cuff tear. This condition affects the four muscles and tendons that stabilize the shoulder joint and allow full range of arm motion. When one or more of these tendons are torn, it results in pain, weakness, and limited shoulder mobility.
Rotator cuff tears are often associated with repetitive use or trauma, but they can also occur as a natural part of aging. Whether caused by acute injury or years of wear and tear, rotator cuff tears require a tailored approach to treatment. At TSAOG Orthopaedics & Spine, we specialize in providing personalized care for a wide range of specialties, with surgery as a last resort, to help our patients find relief and regain mobility.
In this guide, we cover everything you need to know about rotator cuff tears, including causes, warning signs, treatment options, prevention methods, and when to see a provider.
Understanding Rotator Cuff Tears
The rotator cuff is a group of muscles and tendons that holds your shoulder joint together, allowing you to move your arm in multiple directions and keeping your humerus (arm bone) in the shoulder blade socket. A rotator cuff tear occurs when one or more of the tendons in this group are overstretched, partially torn, or completely severed from the bone.
Rotator cuff tears are classified into two categories, each with two types:
- Acute tears: These occur after an injury such as a fall or after lifting a heavy object with sudden onset of pain or weakness.
- Degenerative tears: These occur gradually over time with general use of everyday life or work.
Acute or Degenerative tears can be two main types:
- Partial Tears: These involve fraying or damage to the tendon without complete detachment.
- Full-Thickness Tears: Also known as complete tears, these involve the tendon being completely torn away from the bone.
Left untreated, a rotator cuff tear can worsen over time, leading to chronic pain, loss of shoulder function, and potential long-term complications.
How Do You Tear a Rotator Cuff?
Rotator cuff tears can happen suddenly or develop gradually. Here are the most common causes:
Repetitive Motion or Overuse
Frequent overhead movements or repetitive shoulder use can strain the rotator cuff over time. Athletes in sports like baseball, swimming, or tennis, as well as individuals in physically demanding professions, are at higher risk. Over time, repetitive stress can lead to small tears that gradually worsen if not addressed.
Acute Injury
A fall on an outstretched arm, sudden lifting of a heavy object, or a direct blow to the shoulder can cause an acute tear. These injuries often lead to immediate pain and weakness. In severe cases, they may also result in a complete tear that requires surgical intervention.
Degenerative Changes
As we age, the tendons in the rotator cuff naturally weaken. This makes older invidiously more prone to rotator cuff tears, even without a specific injury. Degenerative tears are especially common in people over the age of 40. Reduced blood supply to the tendons over time also contributes to their vulnerability.
Poor Shoulder Mechanics
Improper form during exercise, sports, or heavy lifting can place undue stress on the rotator cuff, increasing the likelihood of a tear. Repeatedly using poor mechanics can also create imbalances in the shoulder that further elevate the risk of injury.
Understanding how rotator cuff tears occur helps identify potential risks and inform preventative measures. Whether caused by repetitive use, acute injury, or age-related changes, addressing these risk factors early can help protect shoulder health. By being mindful of your movements and maintaining proper shoulder care, you can significantly lower your chances of experiencing this painful condition.
What Are 2 Warning Signs of a Rotator Cuff Tear?
Recognizing the signs of a rotator cuff tear early is critical for preventing further damage. Here are two key warning signs:
- Persistent Shoulder Pain: If you experience shoulder pain that doesn’t go away and worsens when you lie on the affected side, it may indicate a rotator cuff tear. Pain at night is a typical complaint with rotator cuff tears. This pain can also intensify with specific movements, such as reaching overhead or behind your back.
- Weakness and Limited Range of Motion: A torn rotator cuff can make it difficult to lift your arm, rotate your shoulder, or perform daily activities. You might notice a significant decrease in strength, particularly when lifting objects or raising your arm.
Other symptoms to be aware of include clicking or popping sounds when moving your shoulder and swelling or tenderness around the joint.
Types of Rotator Cuff Tears
Rotator cuff tears vary in severity and how they occur. Understanding these differences is a vital for selecting the best treatment plan.
- Partial Tear: In a partial tear, the tendon is frayed or damaged but still attached to the bone. These injuries are often painful but may not immediately restrict shoulder function.
- Full-Thickness Tear: A complete tear involves the tendon detaching fully from the bone, causing severe weakness and limited motion. Surgery is often necessary to repair this type of tear.
- Acute Tear: Acute tears occur suddenly, often due to trauma or injury. They may involve significant pain and swelling and require prompt medical attention.
- Chronic Tear: Chronic tears develop gradually due to repetitive use or age-related wear and tear. While they may initially cause mild discomfort, they can progress to more severe symptoms if left untreated.
Rotator Cuff Tear Treatment Options
At TSAOG Orthopaedics & Spine, we recommend a wide range of treatment options tailored to the severity of your condition.
- Immobilization or Rest: For minor injuries or overuse-related tears, resting the shoulder and avoiding strenuous activities may allow the tendons to heal naturally.
- Physical Therapy: A structured physical therapy program can improve shoulder strength, flexibility, and stability to help offload the stress of a rotator cuff tear and improve the mechanics of the shoulder and back muscles to restore function.
- Activity Modification: Avoiding movements that strain the shoulder, such as overhead lifting, can help reduce stress on the rotator cuff and promote healing.
- Steroid Injections: Corticosteroid injections are a non-invasive option for reducing inflammation and managing pain, especially for partial tears or tendonitis.
- NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can alleviate pain and swelling, allowing patients to participate more effectively in physical therapy.
- Platelet-Rich Plasma (PRP) Injections: This innovative treatment uses your own blood to accelerate healing. PRP therapy is particularly promising for patients with partial tears.
- Surgery: When non-invasive treatments fail, or the tear is severe, surgery may be required. Minimally invasive arthroscopic surgery offers faster recovery times and excellent outcomes for patients with full-thickness tears.
For more information about rotator cuff treatments, check out our additional blogs in this series:
- What is the Best Treatment for Rotator Cuff Injury?
- When and When Not to Have Rotator Cuff Repair Surgery
- How Long Does it Take a Torn Rotator Cuff to Heal Without Surgery
- What to Expect Before and After Rotator Cuff Surgery
- How Long After Rotator Cuff Surgery Can You Drive?
Rotator Cuff Tear Prevention Methods
Preventing rotator cuff tears starts with taking proactive measures to strengthen and protect your shoulder. These methods can reduce the risk of injury and help maintain shoulder health over time.
Strengthening Exercises
Incorporate exercises that target the rotator cuff muscles and surrounding areas to build stability and resilience. Simple resistance band exercises, such as external rotations or shoulder presses, can be highly effective in fortifying the muscles that support the joint.
Proper Technique
Proper form during sports or physical activities is essential to avoid unnecessary stress on the rotator cuff. Whether you’re lifting weights, swimming, or throwing, ensure your movements are controlled and avoid overextending your shoulder. Seeking professional guidance can help refine your technique and minimize injury risks.
Avoid Overuse
Overuse is a common cause of rotator cuff injuries. If your activities involve repetitive shoulder movements, take frequent breaks to allow your shoulder to recover. Alternating between high-impact and low-impact tasks can also help prevent strain.
Maintain Flexibility
Stretching the shoulder muscles regularly improves flexibility and reduces stiffness, which can contribute to injuries. Dynamic stretches before activity and static stretches afterward are especially beneficial in maintaining a healthy range of motion.
By integrating these habits into your routine, you can significantly lower the likelihood of rotator cuff tears and enjoy better overall shoulder health.
When To Contact a Healthcare Provider About a Rotator Cuff Tear
If you’re experiencing persistent shoulder pain, weakness, or restricted movement, it’s time to consult a specialist. Rotator cuff tears that go untreated can lead to further complications and prolonged discomfort.
At TSAOG Orthopaedics & Spine, our team of orthopedic specialists is committed to providing personalized care. Whether you require non-invasive treatments or advanced surgical intervention, we’ll guide you every step of the way.
Don’t let shoulder pain hold you back. Book an appointment and start your journey toward recovery.
