What is a rotator cuff tear?
The shoulder joint has the greatest amount of motion so that we can move our arms in every direction. To do all these movements our rotator cuff muscles provide the stability we need to keep the joint in place. The rotator cuff consists of the supraspinatus, infraspinatus, subscapularis and teres minor muscles. Rotator cuff tears can occur in any of the four muscles but it is the supraspinatus that is the most frequently torn muscle. The tears can vary in size they can be a partial or full thickness tear.
Signs and symptoms
- Acute tears will experience more intense pain and will have difficulty in lifting your arm.
- Chronic tears will have less intense pain but will typically describe a deep dull ache in the shoulder.
- difficulties sleeping on the shoulder
- difficulty with overhead activities, across the body activities or lifting certain objects such as a kettle because of weakness and pain.
What causes rotator cuff tears?
Rotator cuff tears can be acute or chronic. Acute tears happen from trauma like falling on the shoulder or lifting a heavy weight overhead quickly. Chronic tears occur from long term fraying of the muscle. People who are more prone to developing chronic tears are people who spend excessive amounts of time performing overhead activities such as painters. Chronic tears are more common in people who are over the age of 65 years old.
- Activity modification. An initial change to your exercise regime or daily activities may be needed to avoid the condition getting worse. Activity modification will very depend on the severity and type of tear. An assessment by the physiotherapist will be able to give you advise and education about activity modification.
- Anti-inflammatory. Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen will help with pain and swelling as per GP instructions.
- Strengthening/Isometric loading. The exercise program will vary for acute and chronic tears. For both types of tears It is important that strength is addressed for this condition so that the affected area can tolerate more load. This is done initially with isometric loading to load up the affected area in a pain free way. For chronic tears the physiotherapist will assess posture and shoulder blade muscle function to address all areas that may have contributed the tissue fraying.
- Taping. Taping of the shoulder can help with pain and education about shoulder position and the effects on pain.
People who have rotator cuff tears should always try conservative treatment first as the outcomes for surgery and physiotherapy are similar.