If you’re having difficulty elevating your arms above your head due to injury from repetitive motion, such as painting, weight lifting, sleeping on your arm for long periods of time, chronic rotator cuff tears, playing a sport (swimming, tennis serve, throwing a baseball/softball/football), or an attempt to prevent yourself from falling, then you may have a shoulder impingement, rotator cuff tendinitis, or a torn rotator cuff.
In this article, I will discuss rotator cuff tears. There are two types of rotator cuff tears, partial and complete. Partial tears are incomplete tears that do not completely detach from the bone. The best treatment for a partial tear is rest and physical therapy. Complete tears (complete full thickness tears) go completely through the tendon. Surgery is recommended for this type of tear. Rotator cuff tears can be caused by the extension of the arm outward as you fall and the lifting of heavy objects, such as weights overhead (power cleans, shoulder snatches, kettle bell swings, etc.). A chronic tear occurs gradually. The chronic tears begin as tendonitis or a shoulder impingement. Overtime, the tendons wear down and tear.
Patients who have rotator cuff tears may experience intense pain after a sudden fall and possible shoulder weakness on the affected side. Difficulty moving the affected shoulder may occur, and patients may hear a popping or crunching sound during movement. As always, if you’re experiencing any of these symptoms, please contact your primary care physician for a shoulder X-Ray to assess the bone structure and an MRI or CT scan to assess soft tissue, tendons, fluid buildup (possible bursitis), and possible tears. Rotator cuff tears are treatable with rest, ice packs and heating pads for 20 minutes four times per day interchangeably, and physical therapy. NSAIDS (Advil, Aleve, Naproxen, ibuprofen, etc.) are effective for managing the pain and swelling. Steroid shoulder injections may be effective. Depending on the results and the level of pain, a referral to an orthopedic surgeon may be necessary.
The shoulder is formed where the humerus, collar bone (clavicle), and scapula join. The rotator cuff holds the humerus in place. The muscles that form the shoulder are the supraspinatus, infraspinatus, tres minor, subscapularis, and deltoid. There are four rotator cuff tendons and two biceps tendons that make up the shoulder. These tendons connect the deep layers of the muscles to the scapula and humerus,and provide support to the glenohumeral joint. The supraspinatus tendon is the most affected tendon due to overuse and trauma. The supraspinatus muscle is responsible for lifting the arms out to the side. An injury to this muscle can result in possible rotator cuff tear(s). Overuse can lead to shoulder (subacromial) impingement.
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