Dr. Owen McConville
In the United States, rotator cuff injuries are a common cause of shoulder pain. Rotator cuff injuries are known to cause weakness in the shoulder, making everyday activities that involve reaching your arm above your head painful, such as getting dressed and brushing your hair. Even though rotator cuff injuries are common, it is important to understand that all rotator cuff injuries are not the same.
What is a Rotator Cuff?
To fully understand a rotator cuff injury, it is important to understand the anatomy of the shoulder. The rotator cuff holds your shoulder in its socket and is made up of four muscles that come together forming tendons. These tendons, known as the rotator cuff, form a covering around the head of the humerus, attaching the humerus to the shoulder blade. The rotator cuff aids the shoulder in lifting and rotating the arm.
Types of Rotator Cuff Tears
There are two main types of rotator cuff tears, as follows:
- Full-thickness Tear: A full-thickness rotator cuff tear occurs when the tendon is completely separated from the bone, creating a “hole” in the tendon.
- Partial Tear: A partial tear occurs when the tendon is damaged, but not completely separated from the bone.
How Does a Rotator Cuff Tear Occur?
Rotator Cuff tears are usually the result of an injury, such as a fall, or degeneration, which means your tissue wore out over time as a result of aging. How your tear occurs and the level of severity of the tear determine how the rotator cuff injury is treated. In some cases, rotator cuff injuries can be treated without surgical intervention, whereas in other cases, surgery may be necessary to repair the damage.
Facts You Should Known About Rotator Cuff Injuries
As stated above, all rotator cuff injuries are not the same and therefore should not be treated as such. Below are a few facts you should know about rotator cuff injuries and their differences.
- When the rotator cuff experiences a large tear, it can cause the tendon to retract, or pull back towards the opposite end. The larger the tear, the more likely the tendon is to retract. Once the tendon retracts and is not being used, overtime the body will turn the unused muscle into fat. Rotator Cuff’s that have retracted over 3 centimeters may be more difficult to repair. Additionally, once the muscle is turned to fat, there is no way to turn the fat back into muscle. Therefore, it is important to seek treatment for suspected tears promptly.
- Degeneration is the most common cause of rotator cuff injuries. In most cases, tears caused by degeneration are very small and surgery can be avoided. However, it is important to note that at times these small tears can become larger and may require surgical intervention.
- If your rotator cuff tear is a result of an injury, suching as falling on your side, surgery most likely will be recommended. A traumatic injury causes a normal, healthy tendon to tear, resulting in significant shoulder weakness. If you have suffered trauma to the shoulder and are experiencing pain and weakness, do not hesitate to contact an orthopedic doctor for evaluation. A large tear to the rotator cuff could cause the tendon to retract.
- There are many individuals that are living with small rotator cuff tears and not experiencing symptoms. In cases such as these, surgery is not necessary to repair the damage.
- In some cases, such as if retraction has occurred, surgery to repair a damaged rotator cuff may fail to provide the desired results or the results may degrade over time, specifically if you have fat replacement of the muscle.
Questions to Ask Your Orthopedic Expert
In summary, it is important to ask your orthopedic expert questions when dealing with a rotator cuff injury such as the following:
- How large is the tear?
- Can the tear be treated using non-surgical methods?
- What are my options?
- Is the tear retracted? If so, how far?
- Do I have fat replacement of the muscle? If so, how much?
It is also important to share your goals with your orthopedic expert so they can help you achieve these goals. For example, if you are an avid tennis player and your goal is to get back on the court, your orthopedic expert will want to know.
Learn More
If you have been diagnosed with a rotator cuff tear and wish to seek a second opinion, or if you are experiencing shoulder pain, we invite you to explore South Shore Orthopedics. Our team of orthopedic surgeons are experts when it comes to the diagnosis and treatment of rotator cuff injuries and specialize in conservative methods of treatment. Request an appointment today!