Rotator cuff tears

Your shoulder’s rotator cuff keeps your upper arm bone (humerus) in your shoulder socket. The tendons in the rotator cuff can tear from either an injury or degeneration.

A rotator cuff tear means one or more tendons no longer fully attach to the head of the humerus. A rotator cuff injury will weaken your shoulder and cause pain during sports and daily activities. A tear is a common injury, and our orthopedic specialists are experts in all forms of treatment.

Find treatment locations for rotator cuff tears
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Rotator cuff tears: signs, symptoms and risk factors

According to the American Academy of Orthopedic Surgeons, almost two million people a year in the U.S. visit a doctor because of a rotator cuff problem. There are two different types of tears:

  • Partial tear, or an incomplete tear. Damages the tendon, but does not completely sever it.
  • Full-thickness tear, or a complete tear. Completely tears all of the tendon from the bone so that there is basically a hole in it. The supraspinatus tendon is the most commonly injured tendon.

The type of tear determines the severity of symptoms, which can include:

  • Grating or cracking sounds when moving your arm.
  • Limited ability to move your arm.
  • Muscle weakness.
  • Pain that keeps coming back, especially when doing certain things such as lifting over your head.
  • Pain that prevents you from sleeping on your injured side.

Most tears in young adults are caused by a traumatic injury, but there are other risk factors that we commonly see:

  • Age. Most rotator cuff tears are caused by normal wear and tear, so people over 40 are at greater risk.
  • Repetitive lifting or overhead activities. Painters, carpenters and others who do overhead work are at higher risk.
  • Sports. Athletes are vulnerable to overuse tears, especially tennis players and baseball pitchers.

Diagnosis and treatment for rotator cuff tears

Your provider will take your complete health history and conduct a physical exam, and you may also need diagnostic tests, such as:

  • X-ray. Will not show a rotator cuff tear, but will help your provider rule out bone spurs and other conditions.
  • Magnetic resonance imaging (MRI) or ultrasound. Gives very detailed images of your shoulder joint structures.

Based on this, your provider will develop the right treatment plan for your injury and lifestyle.

Nonsurgical treatment

For the majority of our patients, nonsurgical treatment successfully relieves pain and improves function, which may include:

  • Activity modification. You may need to avoid certain activities, especially anything overhead.
  • Corticosteroid injection. Cortisone can be a very effective anti-inflammatory medicine in some cases, injected directly into the injured tendon.
  • Nonsteroidal anti-inflammatory medication. Drugs like ibuprofen and naproxen can reduce pain and swelling.
  • Rest. Your provider may prescribe a sling to help keep your shoulder still.
  • Physical therapy. A physical therapist will teach you exercises to improve flexibility, restore range of motion and strengthen your shoulder.

Surgical treatment

Your doctor may recommend surgical treatment based on your diagnosis, or if nonsurgical methods aren’t adequately relieving your pain. UCHealth specialists have deep experience in any procedure you might need, including:

  • Arthroscopy. Your surgeon inserts a thin tube fitted with an HD camera and surgical tools, called an arthroscope, through a tiny incision(s) and reattaches the torn tendon to the bone.
  • Open tendon repair. Your surgeon makes a large incision and reattaches the damaged tendon to the bone through traditional methods.
  • Shoulder replacement, or shoulder arthroplasty. Serious rotator cuff injuries may require a replacement with an artificial joint.
  • Tendon transfer. Your surgeon may decide to replace a seriously damaged tendon with a nearby tendon.

Recovery from rotator cuff tears and return to sports

Fortunately, many of our patients need only physical therapy and other nonsurgical treatments—and they’re fully active again in four to six weeks. If you need surgery, recovery will take three to six months, depending on the procedure.

We’re here to help you overcome a rotator cuff tear and get back to the activities that make you healthy and happy.

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References

Orthoinfo: American Academy of Orthopaedic Surgeons. Rotator Cuff Tears (https://orthoinfo.aaos.org/en/diseases–conditions/rotator-cuff-tears/)

MedlinePlus: National Library of Medicine. Rotator Cuff Injuries (https://medlineplus.gov/rotatorcuffinjuries.html)

National Center for Biotechnology Information (NCBI): National Library of Medicine. Rotator Cuff Injury (https://www.ncbi.nlm.nih.gov/books/NBK547664/)