Rotator Cuff Tear

Rotator Cuff Tear

The rotator cuff tear or rotator cuff tear is an injury in the shoulder area that usually requires treatment. Although prevention is only possible to a limited extent, early therapy can often restore full functionality.

What is a rotator cuff tear?

A rotator cuff tear is a tear in the so-called rotator cuff. This rotator cuff is located in the shoulder and is, among other things, jointly responsible for the stabilization of the shoulder joint. For infection definition, please visit electronicsmatter.com.

A rotator cuff tear can affect four different muscles and associated tendons that make up the rotator cuff; such as the superior or inferior bone muscle or the inferior scapula muscle. The symptoms associated with a rotator cuff tear depend, among other things, on the extent of the tear; however, it is not uncommon for smaller tears to cause more pain than more severe tears do.

Typical signs of a rotator cuff tear are primarily shoulder pain, which varies depending on different loads and positions of the rotator cuff. Typically, a rotator cuff tear causes pain when lifting your arm to the side. A rotator cuff tear mainly affects men who have already reached the age of 30.

Causes

A rotator cuff tear can have a variety of causes. In most cases, the rotator cuff only ruptures if the corresponding tendons are already damaged. One possible cause of a rotator cuff tear is so-called degeneration, i.e. wear and tear of the rotator cuff.

Such wear and tear can be favored, for example, by long-term professional activities that include a lot of overhead work or by so-called overhead sports; these sports include, for example, golf or tennis.

Another cause of a rotator cuff tear can be an impairment of the tendons caused by a lack of space in the corresponding tendons in the shoulder area. And finally, accidents such as falls on the shoulder or arm can also lead to a rotator cuff tear.

Symptoms, Ailments & Signs

The rotator cuff tear is characterized by the appearance of various symptoms. This is mainly pain in the shoulder. These can appear suddenly or develop gradually, depending on the extent of the tear. The pain is usually position or load dependent.

In addition, they often occur at night when the patient is lying on the affected side of the body. Raising the affected arm to the side against resistance usually also causes pain in the upper arm or shoulders. It hurts particularly badly when the abduction angle is between 60 and 120 degrees.

In the case of smaller tears, however, the rotator cuff tear can even remain asymptomatic. However, it also happens here that the pain slowly develops and intensifies over a period of about two days. Older people often suffer from very slowly increasing pain over a long period of time. This can make it difficult for them to diagnose the disease. Overall, the symptoms lead to a decrease in strength in the arm.

As a result, those affected can no longer carry out certain activities. Symptoms depend, among other things, on whether the tear occurred before or after tendinitis, the cuff is partially or completely torn, and the period over which the changes developed. In severe cases, the pain also occurs at rest.

Diagnosis & History

A suspected diagnosis of a rotator cuff tear can initially be made on the basis of typical painful symptoms in the shoulder; a characteristic weakening of the musculature, which is associated with a rotator cuff tear, can also confirm a suspected diagnosis.

Both muscle weakness and impairment of movement can be determined by a diagnostician during a physical examination using various tests. If necessary, so-called imaging methods can be used in a further step for a detailed diagnosis; these include, for example, X -ray or ultrasound examinations.

Basically, the course of a rotator cuff tear depends, among other things, on the severity of the tear. However, if a rotator cuff tear is recognized early and, if necessary, treated medically, full functionality can be regained in most cases.

Complications

Depending on how severe the rotator cuff tear is, various complications are possible. This risk is considered to be particularly high if the crack is not properly treated. One of the conceivable consequences of a tear in the rotator cuff is joint wear and tear (omarthrosis) in the shoulder.

In medicine, this form of arthrosis is also referred to as defect arthropathy. Another possible effect is the so-called frozen shoulder. This shows movement restrictions of the shoulder joint, which can no longer be reversed even with the help of treatment. If the rotator cuff tear is due to wear and tear, which is the case in most patients, the affected tendons can tear repeatedly at a later moment.

The greater the extent of the previous damage, the more likely it is that there will be another crack. In the case of severe impairments, the frequency of repeated ruptures is around 70 percent. After considering the degree of severity, on average every fourth patient suffers a renewed rotator cuff tear in the course of his or her life.

If the rotator cuff tear is treated surgically, there is also a risk of complications. These primarily include wound healing disorders, infections, restricted mobility, another rotator cuff tear and a permanent deficit in strength. In addition, residual symptoms can remain. If the nerves are injured, there is a risk of paralysis or sensory disturbances.

It can take four to six months for the patient to stop feeling any discomfort after the operation. Activities that put a strain on the shoulder should only be repeated after three to four months in order to avoid negative effects.

When should you go to the doctor?

A rotator cuff tear should always be evaluated and treated by a doctor. As a rule, this disease cannot heal itself, so that the patient is always dependent on medical treatment. This can prevent further complications. A doctor should be consulted for a rotator cuff tear if the affected person suffers from severe shoulder pain.

This pain often spreads to other regions of the body and can lead to symptoms there. This pain can also occur at night and disturb the sleep of the person concerned. In most cases, the pain occurs when the person concerned twists or bends their shoulder excessively. A decrease in arm strength may also indicate a rotator cuff tear and should be evaluated.

First and foremost, the rotator cuff tear can be examined by a general practitioner. In some cases, further treatment may require surgery.

Treatment & Therapy

A rotator cuff tear usually requires medical treatment. Targeted therapy for rotator cuff tears depends on various factors: the severity of the rotator cuff tear plays a role; for example, there can be a complete tear, but also only a tear in one or more tendons.

Furthermore, an adapted therapy depends on the extent of the pain, the age of the patient and the degree of resilience of the rotator cuff. As part of the therapy, the strength and functionality of the affected shoulder should be restored and freedom from pain should be achieved.

Treatment of a rotator cuff tear can be either surgical or conservative (non-surgical). Surgical treatment of rotator cuff tears is often possible with the help of what is known as arthroscopy (joint endoscopy); this method, which is also known as keyhole surgery, makes a so-called open operation with a large skin incision unnecessary.

Possible components of a conservative treatment of a rotator cuff tear are, for example, anti-inflammatory and pain-relieving drugs or injections as well as physiotherapeutic (physiotherapeutic) measures.

Prevention

Preventing a rotator cuff tear is only possible to a limited extent. If the tendons are already damaged, long-term overhead activities pose a risk of suffering a rotator cuff tear. For example, it can make sense for amateur athletes who have already suffered a rotator cuff tear to practice a sport in which the arms and shoulders are only subjected to limited stress. For example, jobs that require frequent overhead work include painting and decorating.

Aftercare

Follow-up care is particularly necessary for surgical treatment of rotator cuff tears. After the procedure, the rotator cuff needs enough rest to heal. It usually takes six to eight weeks to be able to exercise. A special cushion is placed on the patient to protect him. He has to wear this consistently for a period of four to six weeks.

He should only remove the pillow to get dressed or to clean his body. In addition, he is not allowed to move the treated arm in the lateral or forward direction. This puts you at risk of tearing the rotator cuff again. The treated arm can also be immobilized with a sling (orthesis).

The shoulder is mobilized passively and as part of physiotherapy. This means that the patient is not allowed to move his arm himself. The movements take place exclusively through the therapists. Active mobilization follows passive mobilization.

The shoulder can move independently again. Strengthening the muscles also plays an important role. However, the shoulder should not be heavily loaded for about ten to twelve weeks. Physiotherapeutic follow-up treatment can restore the functionality of the shoulder for everyday life, which can take up to six months.

You can do that yourself

This painful condition belongs in the hands of a doctor. The family doctor will decide whether conservative or surgical treatment is necessary in the present case. The tear will not heal on its own, and a rotator cuff tear usually leads to further tears.

This is the reason why, from now on, sports such as climbing, golf or tennis may no longer be practiced. Even if the patient is able to raise their arm above their head without pain after successful treatment, they are provoking a new rupture. This also applies to people with jobs that require overhead work, such as painters and varnishers. Retraining is recommended here.

A rotator cuff tear can lead to joint wear and tear and thus to omarthrosis, i.e. a specific form of osteoarthritis. In order to prevent this, patients are advised to take their painkillers, such as ibuprofen, regularly, as they not only reduce the pain, but also the inflammation.

Alternative medicine also recommends various dietary supplements and phytotherapeutics that are said to have anti-inflammatory properties. These include certain enzymes such as bromelain, but also glucosamine, chondroitin, claw thorn (cat’s claw), Boswellia serrata (frankincense) and the sulfur compound methylsulfonylmethane, MSM for short. Doctors with a naturopathic background or appropriately specialized non- medical practitioners provide more detailed information on their intake and effectiveness.

Rotator Cuff Tear