Rotator cuff tears (a tear in a tendon) are caused by the aging process, acute trauma, or repetitive overhead work or sports. Common examples of activities that can cause rotator cuff tears are swimming, golfing, and tennis. Rotator cuff tears are more common in people who are over the age of 40, especially those who are in their late 50s or older.
Most rotator cuff tears occur gradually. It may cause pain in the front of your shoulder that radiates down the side of your arm. Some people have pain sleeping on the affected shoulder. The intensity of the pain increases over time, and the tear may cause stiffness and loss of motion. If you’re still in pain and your shoulder isn’t getting better after three to four weeks, see an orthopaedic doctor. If the tear occurs with an injury, you may feel sudden acute pain, a snapping sensation, and an immediate weakness of the arm. See a doctor right away. Doctors diagnosis a rotator cuff tear based on your symptoms, an examination, X-rays, and imaging studies such as MRI.
The goal of treatment is to relieve pain and improve function. This can often be accomplished without surgery. The type of treatment depends upon the size of the tear and the patient’s age. For smaller tears, doctors often use physical therapy, steroid injections, and strengthening exercises. Large or massive tears generally need to be repaired surgically, usually through minimally invasive arthroscopy. In arthroscopy, the surgeon uses a lighted, tube-shaped instrument called an arthroscope. The arthroscope, which is the width of a pencil, is inserted into a small incision (called a portal) in the side of the joint. People who have surgery to repair rotator cuff tears tend to do very well.