Rotator Cuff Tears
Torn Rotator Cuff Tendon Treatment
Rotator cuff injuries affect everyday life in a multitude of ways. They cause pain while extending and using the arm, bending over to tie your shoes, and even while taking deep breaths. Thus, they’re very life-changing for many people. These injuries affect your quality of life and ability to enjoy the things you once did. That’s why it’s important to treat rotator cuff tears as soon as possible with the help of a Dallas orthopedic specialist.
At SPORT Orthopedics and Physical Therapy, our top priorities are to provide you with the best treatment possible, and to get you back to doing what you love. Whether you suffered your injury playing sports or from an accident, we pride ourselves on offering a multitude of different treatment options. The same things don’t work for each and every patient, so we provide personalized treatment plans and hands-on recovery. If you suffered a rotator cuff tear and seek treatment, please call our office at 469-200-2832 to schedule your appointment with us.
Rotator Cuff Anatomy
The humerus (upper arm bone), the scapula (shoulder blade), and the collarbone (clavicle) are the three bones that make up your shoulder. The shoulder is a ball-and-socket joint in which the ball (head) of the humerus fits into the shallow socket of the scapula.
Your rotator cuff keeps your arm in the shoulder socket. The rotator cuff is actually a group of four muscles. These muscles come together as tendons and cover the head of the humerus. It attaches the shoulder blade to the humerus, helping you to rotate and lift your arm. We list the four muscle-tendon components below.
- Subscapularis: Runs across the top of the shoulder joint ball, or the humeral head
- Supraspinatus: Runs across the top of the humeral head
- Teres minor: Stretches across the back of the humeral head
- Infraspinatus: Also stretches across the back of the humeral head
Between the rotator cuff and the bone on top of your shoulder lies a lubricating sac called a bursa. When you move your arm, the bursa permits the rotator cuff tendons to slide freely. This bursa can become inflamed and uncomfortable when the rotator cuff tendons are torn or damaged.
Types of Rotator Cuff Tears
A rotator cuff tear might be minor or very sizable. If you continue strenuous activities without seeking treatment , it is possible to rupture more than one tendon. You could also worsen the tear. It’s critical that you get the correct treatment for your rotator cuff to return to normal functioning, or close to it. Below, we list the different types of rotator cuff tears.
- Partial tear: This describes a damaged rotator cuff tendon. The tear does not go all the way through. Some call this a partial thickness tear.
- Complete tear: This occurs when the soft tissue splits into two parts. In many cases, the tendons completely tear away from the arm bone. Full thickness tears, or complete tears, do not heal on their own. This is because the muscles in the area pull the edges of the tear apart. However, partial and full thickness tears can eventually stabilize, leaving you with some relative function.
- Acute tear: Injury or trauma to the area causes these types of tears. For example, maybe you lifted a very heavy object in an awkward way. This has the potential to tear the rotator cuff. Dislocated shoulders, broken collarbones, and other shoulder injuries also hold the possibility of a rotator cuff tear.
- Degenerative tear: Many rotator cuff injuries are caused by the gradual deterioration of your tendon and can have a variety of causes. They can be caused by genetics as well as specific health problems such as excessive cholesterol and diabetes. As a result of this, your dominant arm is more prone to develop a rotator cuff tear since it is used more frequently and is subjected to repetitive stress. As you become older, your body gradually degenerates, increasing your risk of injury.
What Causes Rotator Cuff Tears?
The two main causes of rotator cuff tears are injury and gradual degeneration. You can tear your rotator cuff if you fall on your extended arm or lift anything too heavy with a jerking action. Other shoulder injuries, such as a broken collarbone or a dislocated shoulder, can cause this sort of tear.
The majority of tears develop as a result of the tendon gradually wearing down over time. As we become older, our bodies inevitably degenerate. The dominant arm is more prone to rotator cuff injuries. Even if you don’t feel discomfort in the opposite shoulder, if you have a degenerative tear in one, you’re more likely to have a rotator cuff tear in the other. Below, we list the factors that contribute to the wear and tear of rotator cuffs.
- Repetitive stress: Repeating the same shoulder motions over and over might cause your rotator cuff muscles and tendons to become overworked. Baseball, tennis, rowing, and weightlifting are just a few examples of sports that can cause tears from overuse. Overuse tears can be caused by a variety of occupations and household tasks.
- Lack of blood flow: The blood flow to our rotator cuff tendons decreases as we age. The body’s natural capacity to heal muscle strain is hampered without enough blood flow. This can eventually result in a tendon tear.
- Bone spurs: Bone spurs on the underside of the acromion bone are common as we become older. The spurs rub on the rotator cuff tendon as we lift our arms. This is known as shoulder impingement, and it weakens the tendon over time, making it more prone to ripping.
Symptoms of Rotator Cuff Tears
The most common symptoms of rotator cuff tears include the following.
- Pain both at rest and at night, especially if you put weight on the injured shoulder
- Pain while lifting or lowering the affected arm, or while performing specific motions
- Feelings of weakness in the arm while lifting or rotating
- Crackling sensations while moving the shoulder, or crepitus
Tears that occur abruptly, such as from a fall, are generally painful. There may be a cracking feeling in your upper arm, as well as instant weakening. It’s worth noting that not all rotator cuff injuries are painful. However, arm weakness and other symptoms may still occur as a result of these rips.
Tears that form over time as a result of misuse cause discomfort and arm weakness. When you elevate your arm, you may have discomfort in the shoulder that spreads down your arm. The discomfort may be minor at first, appearing only when you elevate your arm over your head, such as reaching into a cabinet. At first, over-the-counter pain relievers like aspirin or ibuprofen may help.
The discomfort may become more obvious at rest with time, and medicines may no longer be effective. When you sleep on the uncomfortable side, you may experience pain. Routine actions such as brushing your hair or reaching behind your back may become more difficult due to shoulder discomfort and weakness.
How to Diagnose a Rotator Cuff Tear
Your doctor will check your shoulder after discussing your symptoms and medical history. He or she will examine the region to determine whether it is sensitive or if there is a deformity. Your doctor will ask you to move your arm in numerous different directions to determine your shoulder’s range of motion. He’ll also put your arm strength to the test.
Your doctor will examine your shoulder joint for any additional issues. He or she may also examine your neck to rule out other illnesses like arthritis and ensure that the discomfort is not caused by a “pinched nerve.” Other tests include x-rays and MRIs or ultrasounds.
- X-rays: X-rays are generally the first imaging tests conducted. Plain x-rays of a shoulder with rotator cuff pain are typically normal or may reveal a tiny bone spur since x-rays do not show the soft tissues of your shoulder, such as the rotator cuff.
- Magnetic resonance imaging (MRI) or ultrasound: Soft tissues like the rotator cuff tendons can be seen more clearly in these investigations. They can indicate the location of the rotator cuff tear inside the tendon as well as the size of the tear. Because it may indicate the quality of the rotator cuff muscles, an MRI can also help your doctor determine how “old” or “fresh” a tear is.
How to Treat a Rotator Cuff Tear
If you have a rotator cuff tear and continue to use it despite the pain, you risk causing further damage. Over time, a rotator cuff injury might worsen. Seeing your doctor for chronic shoulder and arm discomfort is a smart idea. Early therapy might help you avoid developing worse symptoms. It will also help you return to your regular schedule much faster.
Any therapy should aim to decrease discomfort while also restoring function. A rotator cuff tear may be treated in a variety of ways, and the optimal solution for each person is different. Your doctor will consider your age, exercise level, general health, and the type of tear you have when arranging your therapy.
There is no indication that surgery conducted soon after an accident yields better results than surgery performed later. As a result, many doctors advise treating rotator cuff injuries with physical therapy and other nonsurgical therapies first.
In a large majority of patients, nonsurgical treatment eventually relieves pain and improves shoulder functionality. These treatments include the following.
- Plenty of rest: Rest and minimizing overhead activity may be recommended by your doctor. He or she may also recommend a sling to assist protect and stabilize your shoulder.
- Changes in activity level: Avoid any and all activities that cause you to feel pain in your shoulder.
- NSAIDs: Non-steroidal anti-inflammatory medications help reduce swelling and pain. Examples include ibuprofen and naproxen.
- Strength exercises and physical therapy: Specific exercises can help you regain mobility in your shoulder and strengthen it. Stretching will be part of your workout to increase flexibility and range of motion. The muscles that support your shoulder can be strengthened to reduce discomfort and avoid further damage.
- Steroid injections: An injection of a local anesthetic and a cortisone preparation may be useful if rest, medicines, and physical therapy do not relieve your discomfort. Cortisone is a powerful anti-inflammatory drug, however it is not appropriate for all individuals.
Nonsurgical treatment options have specific advantages and disadvantages. It reduces the risk of infection, stiffness, complications with anesthesia, and a lengthy recovery period. However, the size of the tear could still increase over time, and you will have to limit your activities.
If nonsurgical approaches fail to relieve your discomfort, your doctor may suggest surgery. The major reason for surgery is persistent discomfort. Your doctor may recommend surgery if you are highly active and use your arms for overhead work or sports. Below, we list the other signs and symptoms that might lead a doctor to recommend surgery.
- The symptoms you experience last a long time, from 6 to 12 months.
- Your tear is large, but the surrounding tissue quality is very good.
- The loss of function and weakness in your shoulder is significant.
- Your tear resulted recently, from acute injury.
Rotator cuff repair surgery usually involves re-attaching the torn tendon to the head of the humerus. However, there are other options available, such as a Bankart repair. Speak with your orthopedic surgeon to determine which option meets your needs. Many surgeons opt for shoulder arthroscopy due to its less invasive nature.
What Is Rotator Cuff Tear Recovery Like?
You will have pain following surgery. This is common during the healing process. Your doctor and nurses will strive to decrease your discomfort, allowing you to recover more quickly following surgery.
Following surgery, doctors usually prescribe medication for short-term pain management. Opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anesthetics are just a few of the medications available to assist control pain. To enhance pain relief and reduce the need for opioids, your doctor may prescribe a combination of these medicines.
Rehabilitation is critical in bringing you back to your normal routine. You can restore shoulder strength and motion with the aid of a physical therapy program in Dallas.
Possible Complications of Rotator Cuff Tear Treatment
A low percentage of individuals develop problems after rotator cuff surgery. Complications of rotator cuff surgery sometimes include the following, in addition to the dangers of surgery in general, such as blood loss or issues connected to anesthesia.
- Nerve damage: This usually involves the deltoid muscle nerve which activates your shoulder.
- Infection: After surgery, patients rarely develop infections. To combat this, doctors give antibiotics during the procedure. In the event of an infection, it might lead to prolonged treatment or further surgery.
- Deltoid detachment: The surgeon detaches the deltoid muscle during an open repair surgery. This provides better access to the rotator cuff area. They stitch it back into place once they finish the procedure. In order to allow the area to heal, it is important to take steps to protect it.
- Stiffness: The probability of persistent stiffness or loss of mobility is reduced with early therapy. The majority of the time, more vigorous treatment and exercise will improve stiffness.
- Tendon re-tearing: All types of repairs hold the possibility of re-tearing. In fact, the larger the tear, the more likely this is. Those who experience a re-tear often do not have more pain or less function. Sometimes, it is necessary to undergo another surgery if the tear causes more pain or a loss of function.
How to Prevent Rotator Cuff Tears?
Preventing rotator cuff tears is simple. Following a few simple steps can increase the health of your shoulder muscles and tendons, as well as reduce the risk of injury. Overhead activity, like reaching up high to paint something, changing a lightbulb, or other motions, actually contribute to rotator cuff degeneration.
The shoulder has the greatest range of motion of any joint. The tiny rotator cuff muscles and the bigger muscles that surround the shoulder joint provide the majority of its stability and mobility. Traditional weight lifting and aerobic training have numerous advantages, but they do nothing to develop the complex muscle assembly that keeps the shoulder joint stable and strong.
Exercises that target the muscles that make up the rotator cuff can help you maintain your shoulder’s strength and flexibility. The idea is to combine a program that strengthens the bigger muscles of the shoulder with a few essential rotator cuff movements. Whether you’re active or idle, young or old, these workouts will strengthen your rotator cuff and help you avoid injury.
Rotator Cuff Tear Treatment in Dallas, Frisco, and Prosper, TX
If you suffered a rotator cuff injury, we’re here to help you. At SPORT Orthopedics and Physical Therapy, our team of specialists collaborate to ensure that you receive the treatment you deserve – only the best. Not only do we treat rotator cuff tears, we also treat other shoulder conditions, including frozen shoulder, shoulder dislocations, and snapping scapula syndrome. For more information about the treatments we offer, please call our office at 469-200-2832 today and schedule an appointment with us.