rotator cuff

Have you torn your rotator cuff – or think that you might have?

Rotator cuff tears are a common injury for athletes who play sports like tennis, Australian Rules Football, rugby, and other similar high contact sports.

Sports like swimming or other activities that involve a lot of overhand or overhead motion can also result in rotator cuff tears, along with jobs like painting or other construction work.

What is the rotator cuff?

Your rotator cuff is a capsule of muscles, tendons, and bones that make up your shoulder joint.

It supports your arms at the shoulder joint and is often the problem or source of injury for athletes or anyone who regularly performs tasks that involve a lot of lifting or overhead motion.

These four muscles and tendons allow you to lift and rotate your arm, while also stabilising the bones in your shoulder.

Your rotator cuff – and your shoulder joint in general – is delicate and can easily become unstable, and shoulder injuries or rotator cuff tears can require surgery and physiotherapy, especially if you’ve experienced an acute injury to the shoulder joint.

The anatomy of your rotator cuff

Your rotator cuff is a group of four muscles and the associated bones and tendons that allow you to lift and rotate your arms.

There are two major types of rotator cuff tears – complete and incomplete. The main job of your rotator cuff is to keep to the bones – the ball and socket of your shoulder – firmly in place.

When your rotator cuff is torn or damaged, you can expect pain and a range of future potential problems, including arthritis and frozen shoulder syndrome.

What causes a rotator cuff tear?

Many different activities can cause a rotator cuff tear.

There are two different kinds of rotator cuff tears, complete tears and partial tears.

Partial tears are more likely to be healed through nonsurgical methods as opposed to complete tears, but you should always see a doctor or orthopaedic surgeon if you have shoulder injuries.

While a variety of injuries or conditions can result in a rotator cuff tear, the most common are the result of participating in high impact sports that place a good deal of stress on the shoulder.

What are the signs and symptoms of a torn rotator cuff?

You may have a torn rotator cuff if you have difficulty raising your arm, have trouble lifting things like you normally do, hear or feel popping or clicking noises and sensations when you move your arm, have pain when you move or rotate your arm, feel pain when you lie on the affected side, or have weakness in your shoulder joint.

If you have any of these symptoms, you should see a doctor – ideally an orthopaedic shoulder surgeon – as soon as possible.

What shoulder issues are related to rotator cuff injuries?

There are a variety of shoulder injuries or conditions that can lead to an injured or torn rotator cuff.

If you have dealt with previous shoulder injuries or other shoulder joint issues, you may be more likely to suffer from a torn rotator cuff.

Of course, if you think you have a rotator cuff tear or any other shoulder joint (or any injury in general), you should see a doctor right away.

Shoulder joint problems can lead to greater issues like frozen shoulder or even arthritis if left untreated.

What is a frozen shoulder and what are the stages?

Rotator cuff tears may be related to frozen shoulder syndrome.

If you’ve torn your rotator cuff in the past, it may lead to frozen shoulder or even arthritis, so it is of vital importance to have your shoulder looked at as soon as possible if you suspect that you’ve torn your rotator cuff or suffered a similar injury.

This is the sort of shoulder condition where an ounce of prevention is worth a pound of cure, so get ahead of things and make an appointment with an orthopaedic surgeon as soon as possible if you think have a frozen shoulder.

Degenerative causes for a torn rotator cuff

Like any other joint, your shoulder joints suffer from general wear and tear as you age, particularly if you’re an athlete or work an extremely physical job. These types of rotator cuff tears are referred to as chronic tears caused by repetitive use or overuse of the arm.

You may also tear a rotator cuff if you suffer from tendonitis, which is the degeneration of the tendons in your shoulder and usually caused by old age and repetitive use.

When you have tendonitis, the blood supply to the tendons and muscles of the shoulder is poor, particularly where they attach to the bone.

This means even mild injuries take longer to heal.

Calcific tendonitis occurs when calcium tendonitis forms in the tendons themselves, causing chronic inflammation and injuries that take a long time to heal.

Glenohumeral subluxation can also result in rotator cuff tears; this condition involves a loose shoulder joint where the ball and socket partially dislocate during certain movements.

If you have this issue, then your rotator cuff is subject to more stress and therefore more likely to tear.

Often preventative or nonsurgical treatments can help prevent rotator cuff injuries if you have any of the aforementioned issues.

Working with an orthopaedic surgeon and a physiotherapist can help keep your shoulder joint from degenerating further, so it is essential to make an appointment (LINK) sooner rather than later!

How is a torn rotator cuff diagnosed?

Rotator cuff tears and related injuries are fairly common amongst athletes, especially those who participate in sports that involve a significant amount of overhand or overhead motions, like swimming or tennis.

So when you think you may be dealing with a torn rotator cuff or similar injuries and you enjoy these sports, it is definitely time to see a doctor.

There are various tests and processes for diagnosing torn rotator cuffs and related shoulder joint problems, but your doctor will generally begin with a medical history, a discussion of any previous injuries or activities and sports that you regularly participate in – this conversation is especially important if you’re an athlete or work in construction or a similarly physically demanding profession.

An examination with an orthopaedic surgeon to find out if you have torn your rotator cuff or have a similar shoulder injury.

Your doctor should begin your exam with a full medical history and a physical exam of your shoulder, which will involve moving it into various positions in order to check your range of motion and muscle strength and any pain involved.

Non-surgical treatments for torn rotator cuffs

If you have a minor rotator cuff tear, you may not require surgical intervention. Incomplete or partial rotator cuff tears may heal on their own if you rest and get nonsurgical treatments like physiotherapy and regularly icing the joint, along with pain relief and anti-inflammatory medications.

Of course, always consult with your orthopaedic surgeon and physiotherapist before resuming activities that may aggravate the joint.

Note that if you are a serious athlete or relatively young and active individual, surgery may be advised, especially if you want to continue participating in sports or other activities at a high level.

Depending on your injury, age, and other factors, non-surgical treatment may be all that you need in order to regain the full range of motion and restore scapular control, rotator cuff strength, normal neck-scapulo-thoracic function, power, proprioception, and agility.

Surgical treatments for torn rotator cuffs

Nonsurgical treatment for a torn rotator works for many individuals, but more significant tears or complete rotator cuff tears often require surgery.

Arthroscopic rotator cuff repair surgery is a common solution for more acute shoulder injuries or major tears, particularly if the person dealing with the torn rotator cuff is younger or an athlete.

Arthroscopic surgery to repair a torn rotator cuff can be a relatively simple procedure due to the relatively small incision and non-invasive aspects of arthroscopic surgery in general.

In fact, the surgery to repair a torn rotator cuff can be the simplest part of the recovery process; the rehabilitation and recovery take more time and can require much more effort.

There are a range of surgical options depending on the damage to the shoulder and the type of injury or syndrome, many of which are outpatient procedures.

Naturally, consult with your orthopaedic surgeon as to the best course of action for your specific rotator cuff injuries and your goals for the outcome.

Recovery after a rotator cuff repair surgery

If you have rotator cuff surgery, you should realize that rehabilitation and physiotherapy is a major part of the process and your healing is dependent on following the steps laid out by your doctor and therapist.

Once you’ve had surgery or other treatment for a rotator cuff injury, you’ll most likely be required to do physiotherapy to strengthen the damaged joint and get your full range of movement back (or at least as much as possible).

These exercises should be gentle and low impact movements, meant to help to stabilise your shoulder joint.

They will be performed under the supervision of a physiotherapist.

If you are an athlete or a therapist treating an athlete, these exercises can be designed with a specific sport and role in mind with the goal of getting them back on the field, court, or otherwise in the game as soon as possible.

Some techniques that physiotherapists or trainers commonly use to treat rotator cuff injuries are joint mobilizations (moving the shoulder joint through a series of positions that are meant to improve rotation and flexibility), therapeutic massage, ultrasound treatments, icing the joint and applying heat to the joint in various rotations, stability exercises, and strengthening exercises.

Of course, all of these exercises and treatments are aimed at preventing your shoulder from getting stiff while stretching the muscles in a natural way – and preventing future problems.

Your orthopaedic surgeon and your physiotherapist may also assign you an exercise regimen to perform on a daily basis at home.
While you’re healing, you should also avoid other activities and sports that might cause you to aggravate your rotator cuff injury or shoulder issues in general, and you should wait to resume any exercises or sports until your doctor gives you permission.

Last but definitely not least, you should be aware that once you’ve torn your rotator cuff, you are more susceptible to future shoulder injuries.

During the healing process, you should be careful not to over-exert yourself or over-work the joint, and always check in with your doctor, physiotherapist, and trainers.

How to prevent rotator cuff tears

Proper warm-ups and stretching along with strength training can go a long way towards preventing rotator cuff injuries and rotator cuff syndrome, as well as consulting your trainer and doctor at the first sign of nagging shoulder pain.

While sometimes rotator cuff injuries can be obvious in the case of an acute tear from an impact on the field or at work, rotator cuff syndrome can also creep up slowly over time as the damage accumulates.

This is where having things checked out at the first sign of a problem and engaging in preventative nonsurgical treatment can help decrease rotator cuff pain, strengthen your rotator cuffs, and help prevent greater problems in the future.

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Devinder Garewal Best Orthopaedic Surgeon Shoulder Melbourne

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