Surrounding the shoulder joint is a group of tendons and muscles. Known as the rotator cuff, its function is to keep ball portion of your upper arm bone seated firmly within your shoulder socket. A torn rotator cuff can result in a dull aching in the affected shoulder. When you attempt to use your arm in a position away from your body, the pain might get worse.
Causes of a Torn Rotator Cuff
Simple things like falls can cause rotator cuff tears by dislocating your shoulder or even breaking a nearby bone. However, the more common causes of torn rotator cuffs include:
- Repetitive Use: Continual use of your shoulder, to the point of overuse
- Bone Spurs: These growths can eventually cause a partial or complete tear
- Blood Flow Decrease: A lack of blood flow to the area can make it easier to tear
Symptoms of a Torn Rotator Cuff
While some tears happen gradually, with pain that increases slowly over time but is treatable through pain relief medication, sudden tears can happen by way of an accident and will be accompanied by immediate, extreme pain. Common torn rotator cuff symptoms include:
- Shoulder weakness
- Pain or difficulty when raising your arm
- Shoulder pain that worsens at night or when at rest
- Popping and/or clicking sensations or sounds when moving your arm
How is a Torn Rotator Cuff Diagnosed?
The most basic test that your doctor will perform is a thorough physical examination. This will test for range of motion, tenderness, and overall strength of your arm. More advanced testing that may be used to confirm a diagnosis include:
Non-Surgical Treatments for a Torn Rotator Cuff
Typically, a torn rotator cuff is first treated with conservative measures that you can do at home, such as applying ice to the affected area and resting it. Physical therapy can help increase your flexibility and mobility. Your doctor may also recommend an arm sling to reduce unneeded movement.
If the pain is interfering with your normal activities, your sleep or with your ability to do physical therapy, your doctor might recommend that you have a steroid injection. Physical therapy is both a common treatment for a torn rotator cuff and a vital part of your recovery if you have surgery. Specific exercises tailored to the particular area of your rotator cuff injury can help increase flexibility and strength.
Surgical Treatments for a Torn Rotator Cuff
Ongoing pain after completion of the conservative treatment protocol for a partially torn rotator cuff is one of the main reasons a doctor recommends surgery. In addition, the doctor may suggest surgery for individuals with a partial tear who are very active (e.g., participate in sports or frequently raise their arms over their head while working).
Signs You Might Need Rotator Cuff Surgery
The tear is large (more than 3 cm) and the tissue surrounding the torn tendon is of good quality.
Symptoms are chronic, lasting from six to 12 months.
The tear resulted from a relatively recent, acute injury.
The shoulder is exhibiting limited motion.
The Most Common Torn Rotator Cuff Surgery Techniques
The three torn rotator cuff surgery techniques used most frequently include the all-arthroscopic repair, the mini-open repair and the traditional open repair.
After creating a small incision, the surgeon inserts a tiny camera (i.e., an arthroscope) into the patient’s shoulder joint. The arthroscope allows the surgeon to see inside the shoulder joint via a video monitor. The surgeon uses miniature surgical instruments to repair the torn tendon.
A Mini-Open Repair
The incision for a mini-open repair is usually 3 cm to 5 cm long. During the mini-open repair, arthroscopy is utilized for assessing and treating other structures that have sustained damage. For instance, bone spurs are frequently removed while the surgeon performs arthroscopy. When removing bone spurs during traditional open repair surgery, the deltoid muscle must be detached. However, by removing these spurs during arthroscopic surgery, the patient’s deltoid muscle remains in place.
After completing the arthroscopic portion of the procedure, the surgeon repairs the tendon. While repairing the tendon, instead of using a video monitor, the surgeon views the structures of the shoulder directly.
An Open Repair — Used for a Large or Complex Tear and Reconstruction
The traditional open repair requires an incision that is several centimeters long. The surgeon creates this incision over the patient’s shoulder and then detaches the deltoid muscle. Besides providing the surgeon with a better view, detaching this muscle provides the surgeon with a way to access the torn tendon.
How an Orthopedic Specialist Can Help
For the best outcome when you have a torn rotator cuff, turn to the specialist who have the experience and expertise to deliver excellent care to you. An orthopedic surgeon can help you regain the full use of your arm and address your pain.
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