Rotator Cuff Tear

The rotator cuff is a group of four muscles and their associated tendons that surround the shoulder joint. These tendons attach the muscles to the bone and are responsible for stabilizing the shoulder and enabling a wide range arm movements, such as lifting and rotating to reaching overhead. The rotator cuff is vulnerable to injuries due to the shoulder’s mobility and the cumulative wear over time.

A tear occurs when one or more of these tendons are damaged, either partially or completely, disrupting their ability to function properly. These injuries can be classified into two main categories:

1. Partial Tears: This type involves damage to the tendon without it being completely severed. The tendon may fray or develop small tears that compromise its structural integrity.
2. Full-Thickness Tears: Also known as complete tears, these occur when the tendon fully detaches from the bone, leaving a gap that prevents the affected muscle from performing its intended function.

Rotator cuff tears can occur due to acute trauma, repetitive strain, or age-related degeneration.

• Acute tears often result from trauma, such as falling on an outstretched arm or experiencing a sudden, forceful motion. These injuries are common among younger athletes and individuals engaging in physically demanding activities. However, rotator cuff tears are more common in people of advanced age.
• Atraumatic, degenerative tears, on the other hand, develop gradually due to repetitive stress on the shoulder. This type of injury is common and prevalent in older adults in occupations or sports requiring overhead motions, such as carpentry, swimming, or tennis. Additionally, as individuals age, the tendons of the rotator cuff can weaken, increasing susceptibility to tears even with minor stress or without any specific injury.

• Age: The risk increases significantly after age 40 due to natural tendon degeneration.
• Repetitive Overhead Activity: Occupations and sports requiring frequent overhead motions place undue stress on the rotator cuff. Baseball, softball, tennis, swimming, volleyball, basketball and football, gymnastics, and weightlifting often combine repetitive motions with high force, making proper training, conditioning, and injury prevention techniques essential to avoid rotator cuff injuries.
• Family History: Genetic predisposition may play a role in the development of rotator cuff injuries.

Rotator cuff tears can cause a range of symptoms that vary in intensity based on the severity of the injury. In some cases, small or partial tears may be asymptomatic initially but progress over time, leading to more pronounced discomfort and functional limitations.

Common signs include:

• Pain: This can range from a dull ache to sharp, debilitating pain, particularly when lifting the arm or lying on the affected shoulder.
• Weakness: Difficulty lifting or rotating the arm is a hallmark symptom, especially during overhead activities.
• Limited Range of Motion: Tear-related stiffness can make simple tasks, such as combing hair or reaching for objects, challenging.
• Clicking or Popping Sensation: Some patients report unusual sounds when moving the shoulder, which may indicate mechanical dysfunction.