Rotator cuff tear

What is it?

This is a term used to describe damage to the group of four muscles that surround and act to stabilize the shoulder joint.

Why does it occur?

Tears to the rotator cuff may be complete or partial, either caused by trauma to the shoulder or degeneration over time. Therefore tears are most common in people over the age of 40, but those who perform repeated overhead movements are more susceptible to injury. 

What are the symptoms?

Pain around the joint is the most common concern, this often exacerbated by activity involving overhead movements which may be difficult. Weakness and stiffness can limit normal activities and some can experience pain sleeping on the affected shoulder. A ‘crackling’ sensation may be present when moving the shoulder due to inflamed bursa, fluid sacs surrounding the joint. Conversely, some present with no pain but weakness in their affected arm.

How is it diagnosed?

A detailed history and examination is essential to determine the mechanism of injury and therefore appropriate treatment modality. X-ray, ultrasound and magnetic resonance imaging can then be used to confirm the suspected diagnosis.

How is it treated?

  1. Non-surgical treatment

    Many rotator cuff tears can be managed with pain relief, physiotherapy exercises and steroid injection. This is dependent on the extent of damage to the rotator cuff, patient’s comorbidities and wishes. In most cases the restrictions on function due to tear can be minimal and steroid injections can be very effective in reducing inflammation.

  2. Surgical treatment

This is performed using arthroscopy or ‘key-hole’ surgery, where several small incisions are made around the shoulder joint. A scope is inserted to visualize the affected area and instruments are recruited to clean bone of any scar tissue and reattach the tendon using either plastic or metal anchors. An anaesthetic block is used to numb the arm which can last for several hours after the procedure. You can usually return home the same day after seeing the ward physiotherapist but recovery can be a slow process.