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Shoulder Cuff Tear

Introduction

The rotator cuff is a group of four muscles and tendons that keep the shoulder joint stable.  Sometimes, the rotator cuff becomes inflamed or irritated due to heavy lifting, repetitive arm movements, or a fall.  A rotator cuff tear occurs when injuries to the muscles or tendons cause tissue damage or disruption.

Anatomy

The rotator cuff muscles are important in shoulder movements and in maintaining shoulder joint stability.  These muscles arise from the scapula and connect to the head of the humerus, forming a cuff at the shoulder joint.

Causes

Rotator cuff tears most frequently occur in the dominant arm but can commonly occur in the non-dominant arm.  The risk of rotator cuff damage increases with age.  With age, the blood supply to our tendons decreases and causes the tendons and muscles to degenerate, weaken, and become susceptible to tearing.  Additionally, the tendon degenerates with age. The body’s ability to repair the tendon decreases over time because of the reduced blood supply.  Overuse or repetitive activity can also cause rotator cuff tears. This includes athletes that perform overhead movements during such sports as tennis, swimming, or baseball. It is also common in workers who reach upwards repetitively during construction, painting, or stocking shelves.

Symptoms

The main symptom of a rotator cuff injury is pain.  Many first develop the pain in the front part of the shoulder which may be mild at first, but increases with arm activity.  Over time, the pain may become more constant, affecting sleep.  The shoulder may feel stiff and it might be difficult to move the arm at all.  Also, weakness in the arm may occur when trying to lift or rotate it.  If the injury to the rotator cuff occurred suddenly, you may feel a snap and sudden pain.

Diagnosis

Your doctor will want to perform a physical examination, in which he or she may ask you to perform simple arm movements to help evaluate your muscle strength, joint motion, and shoulder stability.  An x-ray will usually be ordered, but sometimes a soft tissue injury will not show up on this test.  Your doctor may also order an MRI to provide a more detailed look at your shoulder.

Treatment

Whether your shoulder injury requires you to have surgery or not, your doctor will likely send you to see a physical therapist to regain range of motion, muscle strength, and coordination.  Your physical therapist can also help you to modify physical activity so that minimal stress is placed on the shoulder.  Early treatment to this area can help to speed up healing and help to avoid permanent damage.

 

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