An injury to the rotator cuff includes any damage or irritation to the rotator cuff tendons or muscles. A rotator cuff tear is one of the most common injuries impacting the shoulder. In 2008, almost 2 million Americans visited their doctors with rotator cuff injuries. A torn rotator cuff significantly weakens the shoulder, and has a huge impact on your daily life. Activities you perform each day may become difficult and painful. There are two types of tears: a partial tear means the soft tissue is damaged but not completely severed. A full thickness tear means the soft tissue has been split into two pieces. Symptoms include pain throughout the day and at night, especially if lying on the injured shoulder, and pain when performing specific movements. You may have weakness in your arm, and there may be a crackling sound when you move your shoulder.
There are two main causes of torn rotator cuffs: degeneration and injury. An acute tear can happen when you lift something too heavy with a jerking motion or if you fall onto your outstretched arm. This type of tear can also happen when other shoulder injuries occur, such as a dislocated shoulder or broken collarbone. A degenerative tear results when the tendon wears down over time. This can occur naturally as you age, and is more common in your dominant arm (right for most people). There are a few factors that can cause a degenerative rotator cuff tear. Repeating the same shoulder motion over and over again is one of them. This repetitive stress can strain your rotator cuff tendons and muscles. This is common among rowers, tennis players, and baseball pitchers. A torn rotator cuff can also be caused by a lack of blood supply. This usually occurs as you age. Without a strong blood supply, the body cannot repair tendon damage naturally. Lastly, bone spurs can also cause a degenerative rotator cuff tear. When you lift your shoulder or arm, the spurs rub and damage the rotator cuff tendon.
Unfortunately, a torn rotator cuff is not an injury you can play through, and over time it will eventually get better. A rotator cuff tear will actually get larger and worse over time unless it is dealt with. The goal of any treatment is to restore function while reducing pain. For non-athletes, there are several treatment options before surgery is required. These treatment options are successful in about half of all patients, improving function in the shoulder and relieving pain. It generally does not improve shoulder strength, however. You should rest and avoid activities that cause shoulder pain. Your doctor may suggest that you wear a sling to keep your shoulder immobilized and protect it. If over-the-counter medications do not improve the pain, an injection of an anesthetic or cortisone may be recommended. If your symptoms last over half a year, if you have significant weakness, or if you are an athlete and need to return to full strength, you will need to have surgery.