What is a rotator cuff tear?
A rotator cuff tear is a tear in your rotator cuff, a group of muscles and tendons that keep your arm connected to your shoulder. Your rotator cuff helps your arm move, and a rotator cuff tear can limit that movement and cause pain and weakness, making everyday activities a challenge.
Rotator cuff tears are a common cause of shoulder pain, but they are treatable. An orthopedic specialist can work with you to develop a personalized treatment plan that helps reduce discomfort and improve your shoulder mobility.
Anatomy of a rotator cuff
Your shoulder is a ball-and-socket joint where a ball (the head of the humerus, or your upper arm bone) fits into the socket (glenoid) of your shoulder blade (scapula). The ball at the top of your arm fits into a shallow socket in your shoulder blade.
The rotator cuff, made of four muscles, helps hold the arm in place and allows you to lift and move it. The tendons of the rotator cuff cover the top of the arm bone and help with arm movement.
There’s also a small fluid-filled sac called the bursa between the rotator cuff and the top of your shoulder. It helps the tendons move smoothly, but if the tendons are damaged, the bursa can get irritated and cause pain.
When to see a doctor
You should see your doctor if your shoulder and arm pain are persistent and don’t get better with at-home treatments or over-the-counter pain medications. Your doctor should also know if your shoulder pain starts to interfere with your day-to-day activities or a good night’s sleep. If you notice redness or swelling in your shoulder joint, or your shoulder or arm suddenly becomes weak, see your doctor right away.
Rotator cuff tear symptoms
Symptoms of a rotator cuff tear include:
- Pain in the front or outer side of the shoulder
- Pain at night or when lying on the shoulder
- Difficulty raising the arm
- Weakness in the shoulder or trouble lifting objects
- Clicking or popping sounds when moving the arm
If the tear is sudden (acute), the pain is usually sharp. In general, rotator cuff pain can be sharp when reaching up or dull and aching, especially at night or after resting.
Causes of rotator cuff tear
Rotator cuff tears can be caused by injuries (acute) or wear over time (degeneration).
- Acute tear: This type of tear happens suddenly, often due to an accident, such as falling on an outstretched arm or lifting something too heavy with a jerking motion. It can also occur alongside other injuries like a broken collarbone or dislocated shoulder.
- Degenerative (wear-related) tear: Most rotator cuff tears happen slowly over time due to wear and tear. This is a natural part of aging and often doesn’t cause much pain. Tears are more common in the dominant arm and if you have one tear, there’s a higher chance of it occurring in the other shoulder, even if it doesn’t hurt.
Factors that contribute to degenerative tears:
- Repetitive stress: Repeated shoulder movements during sports or on the job can put stress on the rotator cuff and lead to tears.
- Lack of blood supply: As we age, blood flow to the tendons decreases, which reduces the body’s ability to heal damage, leading to tears over time.
Rotator cuff tear risk factors
Anyone can experience a rotator cuff tear. These factors may increase your risk:
- Age: Most rotator cuff tears are caused by wear and tear that may happen with aging and occur in adults older than 40. Younger adults are more at risk of acute tears associated with injuries.
- Genetics: Some evidence suggests that people can be genetically predisposed to rotator cuff tears.
- Existing medical conditions:Shoulder impingement and rotator cuff tendonitis can increase your risk for a rotator cuff tear. If you have a chronic tear in one shoulder, you’re also more likely to develop a tear in your other shoulder.
- Occupation: People with jobs that require repetitive overhead motions, such as painters, carpenters and mechanics, have a higher risk for rotator cuff tears.
- Sports: Athletes have a greater risk for rotator cuff tears due to overuse, especially baseball pitchers and tennis players.
Complications
Without treatment, a rotator cuff tear can get worse and lead to persistent discomfort and bigger issues. Eventually, moving your shoulder and using your arm could become difficult or nearly impossible. Potential complications of an untreated rotator cuff tear include:
- Chronic pain in your shoulder and arm
- Permanent loss of motion
- Weakness of the shoulder joint that makes it difficult to lift your arm
How is a rotator cuff tear diagnosed?
Rotator cuff tears can be diagnosed with a physical exam and medical imaging. The physical exam can help determine whether and what types of imaging can help your doctor confirm a diagnosis or rule out other possible causes of shoulder pain, such as a pinched nerve or arthritis.
Rotator cuff tear treatment
Early treatment can help prevent the pain from getting worse and get you back to your regular activities faster.
There are several treatment options for a torn rotator cuff, all of which focus on reducing discomfort and helping you regain movement and function in your shoulder. Your doctor will develop a treatment plan based on the type of tear you have as well as your age, overall health and activity level.
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Find specialized care for rotator cuff tears
Baylor Scott & White offers several locations for your care in North and Central Texas, so you can find the care you need, where and when you need it. Whether you're seeking diagnostic testing, treatment options or ongoing support for rotator cuff tears, our teams are here to help you.