What is the Rotator Cuff?
The rotator cuff is a set of four muscles that attach your shoulder blade (scapula) to your arm bone (humerus) and assist in reaching up or rotating your arm. These four muscles converge and surround the top portion of the humerus and are thus called the “rotator cuff”. These muscles are not primarily for supplying strength, but instead for allowing smooth, controlled coordinated motion. They are small and delicate and prone to injury.
What is a Rotator Cuff Tear?
Muscles attach to bones through tendons. A rotator cuff tear is typically when the far end of the tendon tears or gets pulled away from the bone. This can occur slowly over time or suddenly in a fall or other accident. In some cases, tearing occurs further up the tendon or in the muscle, but this is less common.
Rotator Cuff Tear Symptoms
Rotator cuff tears that occur suddenly often lead to intense pain and immediate weakness, while tears that develop slowly may cause pain or weakness over time. The most common symptoms associated with a rotator cuff tear include:
- Discomfort or pain at rest and at night.
- Weakness when lifting or rotating the arm.
- Discomfort or pain when lifting or lowering the arm.
- A crackling, popping, or clicking sensation when moving the shoulder.
Types of Rotator Cuff Tears
Overall, different types of rotator cuff tears can occur. These include:
Partial Tear
A partial tear does not completely detach the tendon from the bone. Portions of the tendon are still attached to the bone, but it is thinned. Often the percent tear is important in determining treatment options.
Full-Thickness Tear
With a full-thickness tear, one of the tendons is completely detached from the bone. There are four rotator cuff tendons and a large tear can involve two or more tendons being detached.
Full-Thickness Retracted Tear
A full-thickness tear that develops a gap or separation of the tendon edge from the bone is called a full-thickness retracted tear. This occurs due to the elasticity of muscles pulling the tendon away, like a rubber band.
Diagnosing a Rotator Cuff Tear
To diagnose a rotator cuff tear, your healthcare provider will perform a physical exam and record your symptoms. Often, your doctor can conclude that you likely have a rotator cuff tear based on the assessment but he or she will need imaging studies, usually an MRI or ultrasound, to confirm for sure.
Rotator Cuff Tear Treatment Options
Rotator cuff injury can be addressed with non-surgical and surgical treatment options.
Non-Surgical Options
For many patients, non-surgical treatment options can help to relieve pain and often are the recommended first line of treatment. This may include rest, avoiding activities that cause shoulder pain, physical therapy to strengthen the shoulder, or steroid injections to relieve pain.
Rotator Cuff Surgery
Surgery may be recommended if your pain does not improve with non-surgical options. Arthroscopic rotator cuff surgery is performed on an outpatient basis under general anesthesia. During this procedure, Dr. Goldberg uses a minimally invasive approach to repair any torn tendons to allow for less pain and a quicker recovery. You can read more about rotator cuff surgery and recovery here.
Schedule a Consultation
If you are experiencing symptoms associated with a torn rotator cuff, please contact Steven S. Goldberg, M.D. today for a professional exam. Call us at (239) 316-7600 or contact us online to schedule an appointment in Naples, FL today.
