Bryan Christie

Injury Tip Sheet: Rotator Cuff Tear

Learn what you need to know to help treat and prevent this common shoulder injury

Kathy Weber, M.D., M.S.
Daphne R. Scott, PT, Dsc
Chicago, IL

Fast facts

• The shoulder is one of the most mobile joints in the human body
• The shoulder is also one of the weakest joints and highly susceptible to injury
• Rotator cuff injuries are the most common shoulder ailments
• More common in individuals over forty

What you need to know

What is a rotator cuff tear?

• The rotator cuff is a collection of four muscles that connect your upper arm to the shoulder joint
• The rotator cuff also helps hold your upper arm in place against the shoulder socket and helps stabilize the shoulder joint
• A rotator cuff tear is when any of the muscles or ligaments in the rotator cuff are damaged, either from an injury, tendinitis, degeneration, or overuse
• Most rotator cuff tears occur over time due to normal wear and tear or repetitive overuse

Signs & symptoms

• Pain and weakness in the shoulder joint
• Pain with reaching overhead or behind your back.
• Night pain i.e. unable to sleep on the affected shoulder or find a comfortable sleeping position
• Pain developed after a fall onto the arm or shoulder or pain develops without an injury but is worsening with time
• Catching or popping with activities such as when lifting the arm overhead or reaching your arm behind your back

When should I see a doctor or other professional?

• You should see a doctor if the pain keeps you from your normal activity, you are experiencing night pain, a loss of shoulder motion, or if you have a history of shoulder injuries
• If you experience a fall onto your arm or shoulder and have pain or difficulty with shoulder motion
• Your physician will perform a physical exam and may perform X-Rays and possibly an MRI.  Arthroscopic surgery may be indicated depending on the results of the exam and further imaging

Causes

• Falling heavily on the shoulder or breaking a fall with your arm
• Repetitive heavy lifting
• Repetitive motion that places extreme stress on the rotator cuff muscles
• Degenerative conditions that cause the shoulder muscles to weaken, especially for individuals over 40

Risk factors

• Baseball players, swimmers, and tennis players are particularly at risk
• Any sport with a repetitive overhead motion will exacerbate stress on the rotator cuff

What you can do

Prevention

• It is important to maintain flexibility and strength in the shoulder muscles to help to normal shoulder motion and function
• Ensure that you maintain good posture—poor posture increases the likelihood of the rotator cuff becoming injured
• Be sure to ice the shoulder after intense activity; it will help reduce any inflammation and allow your muscles to recovery quickly

Recommendations for treatment and rehab

• Many rotator cuff tears are treatable at home, with the proper amount of rest and performing a daily rotator cuff home exercise program
• Medications like anti-inflammatories add in reducing swelling and pain associated with rotator cuff injuries.
• Swelling and pain can also be alleviated with regular icing following the injury
• It is important to maintain full range of motion following an injury to the rotator cuff so as not to develop a frozen
• In severe cases, surgery for a severely torn tendon may be needed.  In these cases recovery will require several months of rest and physical therapy

What can I do to stay active?

• Maintain motion in the shoulder by gentle stretching that can be done while lying down and if painful to lift the arm, assist with the opposite arm
• Other forms of exercise such as walking and cycling can continue to be performed

For more information on plantar fasciitis and learn the Six S’s of plantar fasciitis, read our Ask the Expert on plantar fasciitis pain.

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