Christine Mara, DPT
Sports Medicine
Orlando Health
You might have a torn rotator cuff and not even know it. At least not at first. But symptoms can become more painful, eventually making it too difficult to wash your hair or unload the groceries.
One of the most common causes of serious shoulder pain and disability in older adults is a torn rotator cuff. Each year, nearly 2 million people in U.S. seek medical care for these injuries.
Your rotator cuff is a group of four muscles and tendons responsible for keeping your shoulder joint stable and working properly. These muscles keep your arm bone (humerus) attached to your shoulder blade (scapula), while helping you lift and rotate your arm. It’s important for many of your daily activities and for sports like golf or others that involve throwing.
Symptoms of a Torn Rotator Cuff
Often, people with a tear don’t even know it because the symptoms can be minor or nonexistent during the early stages. Except in those rare cases where a fall or some other traumatic injury causes it, you are more likely to notice a gradual onset of symptoms, which can become more intense over time. Symptoms include:
- Shoulder pain: This is usually a dull ache in your shoulder that gets worse at night or when you raise and lower your arm. The pain is rarely severe unless the tear is the result of an injury.
- Difficulty sleeping: The pain may become substantially worse when lying on the side with the damage. Getting a good night’s rest will become difficult as the symptoms worsen.
- Shoulder weakness: The tear degrades shoulder stability, making even simple tasks – reaching for a glass on an upper shelf, for example – a challenge. In severe cases, you may not be able to raise your arm above your chest.
- Popping or crackling in the shoulder: The damage can affect the way the ball of your humerus fits in the shoulder socket. This can cause a feeling of popping or crackling (crepitus) when you move your arm.
What Causes Rotator Cuff Tears?
Rotator cuff injuries become more common as we get older, with most occurring after the age of 40. They tend to be the result of two things. The first is a traumatic injury, often from an unexpected fall or from lifting heavy objects. Dislocated shoulders can also cause a tear.
Rotator cuff tears are more likely to be a combination of aging and general wear. Bone spurs can form on the top of your shoulder bone, where they rub against rotator cuff tendons until they tear. Decreased blood flow can make those muscles and tendons weaker and more vulnerable. Overuse can also be a danger, with tears common among people who have jobs that require repetitive shoulder motions. These include:
- Carpenters
- Mechanics
- Painters
- Athletes who play baseball, softball or tennis
When To Seek Help
Your body will tell you when you need to have a medical professional take a closer look at your shoulder. The big question is whether the symptoms are affecting your ability to perform simple daily tasks. If you can’t perform basic activities without taking pain medication, you should seek an evaluation from a physical therapist or doctor.
Treatment typically starts with physical therapy, where an analysis of your shoulder joint will pinpoint which muscles have been damaged. Then you’ll get a treatment plan to work on improving your strength and range of motion.
With severe tears, surgery may be the best option. But for smaller tears, a conservative treatment plan – along with anti-inflammatory medications – may be all that you need. The torn muscle fibers won’t mend, but the surrounding muscle tissue can be strengthened and built up to compensate for the damage.
Source: Orlando Health, www.orlandohealth.com
