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The rotator cuff is comprised of four muscles – the subscapularis, the supraspinatus, the teres minor, and the infraspinatus – that combine to form a “cuff” over the upper end of the arm, or the humerus. These muscles are what lift and rotate the arm and stabilize the ball of the shoulder within the joint.
The pain of a rotator cuff tear is usually in front of your shoulder that continues down the side of your arm. Because of this pain, it may be difficult to raise your arm overhead, comb your hair, or reach behind your back. Your arm may feel weaker and you may be awakened by pain, especially if you sleep on the affected side.
The two main causes of rotator cuff tears are injury and degeneration. Most tears are caused by the natural wearing down of your tendons. However, if you are an athlete who uses your arms in repetitive motions, such as a baseball pitcher, tennis player, or swimmer, you are more likely to have a rotator cuff injury. Some occupations may make you more at risk as well, including construction jobs, painting, and manual labor.
Rotator cuff tears are more common in the dominant arm.
Rotator cuff tears can worsen or extend over time, especially if you continue to move your arm in the same motions that tore your cuff in the first place without being treated.
If you have chronic pain in your arm, it is best to get it checked out by an orthopedic surgeon. Your doctor may order further diagnostic study, including x-rays and MRIs, to determine the best treatment options. Early diagnosis and treatment of a tear may prevent a permanent loss of motion and loss of strength.
Small rotator cuff tears may be treated non-surgically with anti-inflammatory medications, steroid injections, and physical therapy. These treatment options can relieve pain and restore strength in the other areas of your arm so you don’t strain your rotator cuff. However, larger rotator cuff tears cannot heal on their own and will very likely require surgery. If you are very active or have to lift your arms overhead often because of your job or your sport, surgery may be the best option.
There are several different surgical options, depending on the severity of your cuff tear. You will have to consult with a surgeon to determine which surgery would be most effective for you. You may simply need an arthroscopic surgery. The surgeon creates a small incision and repairs the tear through a camera. This option is relatively pain-free. However, if your tear is more extensive, you may need a traditional rotator cuff repair surgery, or open tendon repair. In this surgery, your surgeon reattaches the damaged tendon to the bone. This option requires a larger incision and the recovery time will be longer than that of an arthroscopic surgery.
One of the most important aspects of treating a rotator cuff tear is the rehabilitation after your surgery. Physical therapy will greatly increase your strength and improve your shoulder’s function after surgery. If you avoid physical therapy, your shoulder will lose motion and strength and could make you more susceptible to future injury.
If you wish to watch animated videos of these surgeries, check out this page on Mayo Clinic.
Dr. Richard Jackson specializes in shoulder surgeries and treatments. If you are suffering from shoulder pain, call our office to schedule a consultation! 317-455-1064.
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