Rotator Cuff Tear

The rotator cuff is a group of four muscles and their corresponding tendons that surround the head of the humerus (upper arm bone). These muscles work together to provide shoulder stability and facilitate movement. The tendons of these muscles attach to the humerus, allowing the shoulder joint to rotate and lift the arm.

The rotator cuff is essential for various shoulder motions, including raising the arm overhead, rotating it inward and outward, and providing strength for pushing and pulling movements. Due to its function and frequent use, the rotator cuff is susceptible to injuries.

A rotator cuff tear occurs when one or more of the tendons in the rotator cuff become partially or completely detached from the bone. When the tendon tears, the connection between the muscle and bone is disrupted, impairing the ability to lift and rotate the arm effectively.

Rotator cuff tears can vary in severity, with some causing only mild discomfort while others lead to significant functional limitations. Left untreated a tear can worsen potentially leading to more extensive damage to the shoulder joint.

Rotator cuff tears can be classified into two main types:

1. Partial Tears: A partial tear is when the tendon is damaged but not completely severed. The tear may fray or thin out over time without fully detaching from the bone. Partial tears can be painful but may still allow for some degree of arm movement.
2. Complete Tears:  A complete tear occurs when the tendon is torn into two pieces, sometimes tearing off the bone This can result in significant weakness and difficulty raising or rotating the arm. Complete tears cannot heal on their own because the muscle movement repeatedly pulls the tear apart.

Additionally, rotator cuff tears can be classified based on their cause:

• Traumatic Tears: These acute tears occur due to a sudden injury, such as falling on an outstretched arm, lifting something too heavy, or experiencing a direct blow to the shoulder.
• Degenerative Tears: These develop gradually over time due to repetitive stress, aging, and wear-and-tear. They are more common in older adults and individuals who engage in repetitive shoulder motions.

Rotator cuff tears can be caused by various factors, including:

• Aging and degeneration: The risk of a rotator cuff tear increases with age due to natural tissue degeneration, reduced blood supply, and gradual wear and tear.
• Repetitive shoulder movements: Individuals who perform repetitive overhead motions, such as athletes (baseball pitchers, swimmers, tennis players) or workers (painters, carpenters, construction workers), are at a higher risk.
• Trauma or Injury: A sudden fall, heavy lifting, or direct impact to the shoulder can result in an acute rotator cuff tear.
• Bone spurs: Over time, bone overgrowth (spurs) can develop in the shoulder joint, leading to impingement of the rotator cuff tendons and increasing the risk of tears.
• Poor posture and muscle imbalance: Weak shoulder muscles, poor posture, and improper biomechanics can contribute to excessive strain on the rotator cuff.

Symptoms can vary depending on the type and severity of tear. Common signs include:

• Shoulder pain: Often felt at the front or side of the shoulder, pain may intensify at night, particularly when lying on the affected side.
• Weakness in the arm: Difficulty lifting or rotating the arm, particularly when reaching overhead or away from the body.
• Limited range of motion: Stiffness and difficulty performing everyday activities such as combing hair, dressing, or reaching behind the back.
• Clicking or popping sensation: Some individuals may feel or hear a clicking sound when moving the shoulder.
• Pain that worsens with activity: The pain may increase with overhead movements, lifting objects, or engaging in activities that involve repetitive shoulder use.