Understanding a Rotator Cuff Tendon Tear

 The rotator cuff is a group of 4 muscles and their tendons in the shoulder. The muscles are located in the front, back, and top of the shoulder joint. They each have a strong band of tissue (tendon) that attaches to the top of the upper arm bone. This helps keep the arm bone firmly in place in the socket of the shoulder joint. The muscles and tendons of the rotator cuff also help the shoulder joint with certain movements. These include reaching the arm over the head and rotating the arm.

Any one of the rotator cuff tendons can fray or tear from causes such as injury and overuse. A tear may be partial, with some of the tendon still intact. Or it may be a complete tear, with the tendon fully torn. Both types can cause pain and weakness, and limit arm and shoulder movement. A rotator cuff tear often needs treatment to heal properly.

Causes of a rotator cuff tendon tear

Causes can include:

  • Wear and tear of the tendons from aging or normal use over time

  • Overuse of the tendons from sports or work activities, especially those that involve repeated overhead movements

  • Injury to the tendons from a fall or other accident

Symptoms of a rotator cuff tendon tear

Some people with a rotator cuff tendon tear have few or no symptoms. Others may have symptoms that range from mild to severe. Possible symptoms include:

  • Pain in your shoulder, which may be worse with overhead movements or at night from lying on the affected side

  • Weakness in your arm and shoulder

  • Trouble lifting your arm up or rotating your arm

  • Clicking or crackling sounds when moving or using your arm and shoulder

Treating a rotator cuff tendon tear

Treatment for a rotator cuff tendon tear depends on several factors. These include the severity of the tear and your symptoms. Options may include:

  • Resting your arm and shoulder. This involves limiting certain movements, such as reaching above your head or lifting your arm up. These can slow healing and worsen symptoms. You may also need to avoid certain sports and types of work for a time.

  • Cold packs or heat packs. These help reduce pain and swelling.

  • Prescription or over-the-counter medicines. These help reduce pain and swelling. NSAIDs (nonsteroidal anti-inflammatory drugs) are the most common medicines used. Medicines may be prescribed or bought over-the-counter. They may be given as pills. Or they may be applied to the skin in the form of a gel, cream, or patch.

  • Injections of medicine into your shoulder. These help relieve pain and swelling for a time. The medicine is usually a corticosteroid, (a powerful anti-inflammatory).

  • Physical therapy and exercises.  These help improve strength, flexibility, and range of motion in your arm and shoulder. 

  • Surgery. You may need surgery if your tendon is completely torn or if other treatments don’t relieve your symptoms. Different options are available. In many cases, the damaged tendon is repairedand is reattached to your arm bone.

Possible complications

  • If a partial tear isn’t given time to heal, it may get larger or tear completely. You may then need more treatment.

  • Even with treatment, a partial or complete tear may sometimes have trouble healing. The problem may become long-term (chronic). This can cause ongoing pain, weakness, and limited movement of your arm and shoulder.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

  • Fever of 100.4°F (38°C) or higher, chills, oras directed

  • Symptoms that don’t get better with treatment, or get worse

  • After surgery, symptoms at the incision sites such as redness, warmth, swelling, bleeding, or drainage

  • New symptoms

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