The rotator cuff is a collection of tendons that are responsible for supporting your shoulder joint. When tears occur, not only is the condition painful, but it can lead to instability of the shoulder. If you suspect a rotator cuff tear or any other shoulder damage, having the problem evaluated quickly can improve your chances of recovery.
Symptoms And Diagnosis
Most cases of rotator cuff tears happen after an acute injury. Since the pain can be severe, it is obvious something is wrong. When tears occur over time, such as because of degeneration of the joint, the problem may not be as obvious. There may be some pain that increases over time along with snapping of the shoulder joint. People with degenerative issues are more likely to seek help when the problem keeps them up at night and they can no longer lie on their shoulder. Your doctor may suspect a rotator cuff tear based on the symptoms, but you will need imaging tests for a diagnosis. X-rays cannot be used to diagnose tears, but they can be helpful in excluding other problems, such as a broken bone or arthritic changes. An MRI is necessary to see the tendons and conclude a tear has occurred.
If tearing is minimal and occurred because of an acute injury, your doctors will likely recommend non-invasive treatments. This can include keeping the shoulder immobilized and allowing the joint to rest until the bulk of symptoms have improved. Pain medications can also help during the healing process, especially NSAIDs, which will reduce inflammation. If there are residual symptoms after several weeks or the problem has worsened, your doctor might recommend other non-invasive treatments, such as steroid injections, which can be more effective at reducing pain and increasing your shoulder function. Depending on the severity of the tear, physical therapy will be recommended to help strengthen the surrounding muscles that help support the joint and to increase the function of the shoulder.
Surgery may be necessary during the acute phase of a rotator cuff tear if the tear is large or the tendons have been severed. For tears that are caused by degeneration of the shoulder, surgery may also be recommended. One way major tears are treated surgically is by reattaching the tendons or suturing larger tears. Most instances of rotator cuff surgery can be done with minimally invasive techniques, such as a completely arthroscopic approach. Using this method, the surgeon inserts a small camera into an incision so they can see the joint and surrounding tissues. Surgical instruments are also inserted into nearby incisions and all repairs are done without a large incision. In some instances, open surgery can be necessary to repair the tendons. Once you have healed from the surgery, physical therapy will be a part of the recovery process.
Most rotator cuff tears are obvious because of intense pain after an acute injury, but slow degeneration of the shoulder can be a less obvious cause. Fortunately, most rotator cuff injuries can be addressed without the need for surgery.
For more information, contact a surgeon like Christopher C. Schmidt, M.D.