Rotator Cuff Tear

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What is a rotator cuff tear?

Rotator cuff tears are very common. According to the Department of Orthopedic Surgery at the University of California, up to 30 percent of the people over the age of 60 have at least a partial rotator cuff tear.

The rotator cuff is a grouping of tendons and muscles that “cuff” the shoulder joint, helping to keep the bone at the very top of your arm in the shoulder’s socket, which helps the arm raise and rotate. A rotator cuff tear refers to one or more of the rotator cuff tendons being torn, either partially (partial tear) or completely (full-thickness tear).

Symptoms

Researchers performed ultrasounds on 664 participants in a study to check the prevalence of rotator cuff tears in the general population. The results, which were published in the Journal of Orthopedics in 2013, showed that of the 147 subjects who were found to have full rotator cuff tears, 65.3 percent of them had no symptoms.

Rotator cuff tear symptoms can range in severity depending on how the injury occurred. A rotator cuff tear that occurs suddenly as a result of a fall or accident generally causes intense pain, which may accompany a snapping sensation and sudden weakness. Symptoms of tears that develop gradually over time from excessive use tend to start off mild and worsen as time goes on, and may interfere with sleep.

Common rotator cuff tear symptoms include:

  • Pain when at rest and at night
  • Pain when lifting and lowering the arm
  • Pain with certain movements
  • Arm and shoulder weakness on lifting or rotation of the arm
  • A cracking sensation (crepitus) when moving the shoulder

What caused my rotator cuff tear?

Rotator cuff tears can happen suddenly as a result of acute trauma or gradually because of degenerative changes (the wearing down of the tendon).

Common causes of acute tears include:

  • Falling on your outstretched arm
  • A car or sports accident
  • Rapid twisting motions of the shoulder
  • Lifting something heavy with your arm fully extended

Common causes of degenerative tears include:

  • Aging
  • Overuse from repetitive shoulder motions
  • Bone spurs
  • Poor blood supply

Risks

The risk of suffering a rotator cuff tear increases as we age because of the degenerative changes that occur from normal wear and tear over the years, especially past the age of 40.

Other risk factors for rotator cuff tears include:

  • Engaging in activities involving repetitive overhead arm motions, such as throwing
  • Occupations and activities involving heavy lifting or excessive stress on the shoulder
  • Weak shoulder muscles from inactivity or injury
  • Shoulder abnormalities or conditions, such as tendinitis or bursitis

Diagnosis

It is important to be certain that your pain is a result of a rotator cuff tear and not another shoulder condition, such as an issue with the ball and joint, which is commonly mistaken for a rotator cuff tear. To confirm a rotator cuff diagnosis, your doctor will take your medical history, discovering what your symptoms are, how long you’ve had them, and whether or not you’ve had an accident that may have caused an injury. The doctor will also perform a physical exam, which may include pressing on different areas of your shoulder and manipulating your arm into different positions to test your range of motion and look for weakness. Imaging tests will likely be ordered and may include one or more of the following:

  • X-ray

    Even though a rotator cuff tear can’t be seen on an X-ray, this is often the first imaging test used to rule out other possible causes of your symptoms, such as fractures or bone spurs.

  • Ultrasound

    Soundwaves are used to produce real-time images of your body’s structures, including soft tissues.

  • Magnetic resonance imaging (MRI)

    This is the preferred type of imaging for diagnosing rotator cuff tears because it allows the doctor to visualize the rotator cuff tendon and its size in great detail. It is also helpful in determining whether the tear happened recently or some time ago. MRI images are created using a magnetic field and radio waves without the use of radiation.

  • Arthrography

    Arthrography uses a special dye injected into the shoulder to highlight damage, including rotator cuff tears. This type of test is often used when a person is unable to have an MRI due to a pacemaker.

  • Treatment

    The goal of rotator cuff treatment is to relieve pain and restore function. There are several options available for treating a torn rotator cuff, and doctors will usually recommend the least invasive options first.

    AROmotion is a cutting-edge solution for pain caused by joint injuries and degenerative disorders, including rotator cuff tears. Our unique, minimally invasive treatment procedures are needle-based, meaning that there is no incision and no surgical recovery period. AROmotion preserves your natural shoulder joint, promotes natural healing, and restores your mobility faster than other treatments!

    Other treatment options include:

    • Rest

      Resting your shoulder and limiting activities that involve reaching overhead or that cause pain is often the first recommended treatment. A sling may be used to immobilize the shoulder. Continued use of the shoulder can worsen a tear.

    • Medication

      Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen and ibuprofen, help to relieve pain and swelling.

    • Physical therapy/exercise

      Special exercises can help strengthen your shoulder and improve your range of motion. Physical therapy can also improve pain and help prevent further injury.

    • Corticosteroid injections

      These injections contain a combination of cortisone and a numbing agent that relieves inflammation and offer quick pain relief.

    • Hyaluronic acid injections

      These injections use a fluid similar to the thick fluid found in our joints that provide lubrication so the joint can move better.

    • Radiofrequency ablation

      Also known as denervation, this is a method of temporarily turning off or blocking the nerves from sending pain signals while other therapies have time to take effect.

    • PRP injections

      PRP, or platelet-rich plasma therapy, injects proteins called growth factors, which help support healing in injured areas.

    • Stem cell injections

      Physician directed stem cell therapy uses very powerful young cells to stimulate the patient’s own native repair mechanisms to regenerate new cartilage.

    • Surgery

      Arthroscopic rotator cuff repair is performed using an arthroscope, which consists of a thin tube with a fiber optic camera on the end. This instrument is inserted into the shoulder through a tiny incision. A video monitor is used to view and repair the damage using small instruments passed through another small incision. Recovery time is considerably less than with traditional open surgery. Surgical treatment (either minimally invasive or open) may be recommended if your rotator cuff tear symptoms fail to improve with less invasive options or have lasted for several months.

    If a rotator cuff tear is preventing you from moving freely and causing you debilitating pain, contact the skilled team at Advanced Regenerative Orthopedics to find out how we can help you get back to a pain-free life!