Rotator Cuff Tear

What is a rotator cuff tear?

A rotator cuff tear, also called a strain is simply a tear of one of the four rotator cuff muscles found in the shoulder. These are the supraspinatus, infraspinatus, teres minor, and subscapularis. The muscles that work together to provide the shoulder joint with dynamic stability. This means they help keep the joint stable while it moves, especially in overhead throwing and racket sports.

The shoulder joint has a very large range of motion (compared to the hip joint) and often needs to move at very high speeds. As a result, there is a higher risk of injury to the muscles and tendons. The supraspinatus and infraspinatus are the most commonly injured rotator cuff muscles, particularly in cricket bowling, pitching in baseball, swimming, and kayaking.

Supraspinatus Tear

The supraspinatus muscle is the most commonly torn rotator cuff muscle. It runs along the top of the shoulder blade and inserts at the top of the arm, or humerus bone, and is one of the four rotator cuff muscles. A supraspinatus tear can occur from falling onto an outstretched arm, or from throwing activities.

Symptoms of a supraspinatus tear include:

• Sharp pain in the shoulder at the time of injury.
• Pain when the arm is rotated outwards and upwards.
• Increased pain and weakness when the arm is raised sideways between a 60-degree arc.

Other Rotator Cuff Tear Symptoms

Torn rotator cuff symptoms at the time of injury will include:

• • Sudden pain in the shoulder which can range from quite mild to severe.
  • It is sometimes accompanied by a feeling that you have torn something in the shoulder.
  • Pain may also radiate down into your arm.
  • Sometimes a snapping sound may be heard, particularly if the injury is more severe
  • You will often be unable to sleep on the injured shoulder as a result of the pain.
  • You may also have signs of shoulder impingement. This is where the tendon pinches between the ball and socket of the shoulder joint, especially when moving your arm overhead.

When should I see a doctor?

• Seek medical attention if your pain persists for more than 2-3 days.
• You are unable to work due to the pain
• Are unable to reach up or to the side with the affected arm after 2-3 days or move the shoulder and arm at all.

What causes a torn rotator cuff?

Rotator cuff injuries are more common in older athletes, particularly if they have a history of long-term overuse. This causes degeneration of the tendon (wear and tear).

• In throwing events it is often the case that injury is caused by rapid deceleration or stopping of the arm once the throw has been released, rather than the acceleration phase of the throw.
• This is why it is particularly important to strengthen the muscles at the back of your shoulder if you are involved in throwing sports, not just the throwing muscles!

Traditional Treatment for a torn rotator cuff muscle

Treatment for rotator cuff tendinopathy consists of two parts. The first priority is to treat the symptoms, reduce pain and inflammation in order to allow normal movement. The second aspect is to address the underlying causes and correct and correct them.

Rest – from activities which cause pain. The more you use the shoulder the longer it will take to heal and it may become chronic. Maintain fitness doing other activities such as running or cycling. Avoid any shoulder exercises or weight training and in particular, avoid the activities which caused the injury in the first place.

Apply ice or cold therapy to reduce pain and inflammation. Ice can be applied every hour for 10 minutes initially reducing to 15 minutes every 3-4 hours as required to reduce pain and inflammation.

Medication – a doctor may prescribe anti-inflammatory medication such as ibuprofen which may help in the early stages but less so long term. Ibuprofen should not be taken if you have asthma and your doctor will always check for contraindications before prescribing medication.

Physical Therapy– a good therapist will help determine the cause of the injury whether that be a poor technique or work-related repetitive overuse and identify strategies or changes to avoid the injury recurring. In particular poor posture and muscle imbalances can be corrected with exercises, taping and workspace evaluation.

Shoulder Sling– A sling can sometimes be useful for more severe rotator cuff injuries. If you still need to go to work school it will immobilize your shoulder, but can be removed at night.

If these treatments fail to improve your pain, surgery may be recommended.