What is a Rotator Cuff Tear?
A rotator cuff tear is a very common muscle injury of the shoulder, commonly caused by sudden traumatic injuries, slow onset overuse injuries in the over 40's, or by degenerative changes in the shoulder joint in the over 50's.
The rotator cuff is a group of muscles that surround and protect the shoulder joint like a collar or "cuff" and provide multi-directional movement to the upper arm, allowing it to rotate, twist and turn.
Rotator cuff tears are categorised by the thickness of the tear:
- Partial thickness tear
- Full thickness tear
They typically commence at the top of the shoulder and spread to the front or back of the shoulder as the severity of the condition worsens.
Dr Manish Gupta brings his experience from the Calvert Shoulder Clinic London to MG Orthopaedics, to offer you the very best diagnosis and treatment advice for your rotator cuff condition. Call 02 9687 8344 to make your booking or use our online booking form here.
Symptoms of Rotator Cuff Tear
A rotator cuff tear can be painful and result in a dramatically reduced range of motion of the shoulder. Rotator cuff tear symptoms may include:
- Shoulder pain at the top and side of the shoulder
- Weakness or loss of shoulder movement making it difficult to reach behind your back or reach upwards
- Inflammation and swelling
What Causes Rotator Cuff Tears?
There are 3 causes of rotator cuff tear, namely sudden traumatic shoulder injury, repetitive overuse injury in the over 40's and degenerative shoulder disease.
Sudden Traumatic Rotator Cuff Injuries
Sudden traumatic injuries of the rotator cuff happen when great or sudden forces cause it to over stretch or forcefully tear. Falling on an outstretch arm or elbow can cause shoulder injury where the rotator cuff may be one of the structures damaged.
Repetitive Overuse Shoulder Injuries
From the age of 40 onwards, most people will begin to suffer muscle and tendon weakening. These changes mean people may no longer be able to generate force like they used to and overloading muscles may lead to tendonitis and tendon rupture. The rotator cuff tendon is susceptible to rupture as we age and we overload it with repetitive overuse activity like swimming, rowing, painting or plastering. The rotator cuff may experience repeated episodes of catching or impinging, which may progress to chronic impingement syndrome and ultimately rupture.
Degenerative Shoulder Disease
Degenerative disease of the shoulder affects over 50's and involves growth of boney spurs around the shoulder, joint disease and worsening blood supply. The effects of trauma and wear and tear are magnified and rotator cuff tear occurs more easily.
Diagnosing a Rotator Cuff Tear
To diagnose a rotator cuff tear, the consultant will question the patient to:
- Understand the nature of the injury (sports, work, accident, overuse etc)
- Determine the cause of the injury (impact, collision, fall, repetitive/slow onset)
- Understand the context of the suffering (age, return to sport, work, impact on daily living)
- Perform a physical examination to ascertain pain and range of movement
- Perform specialised shoulder tests to confirm diagnosis
Partial Thickness Rotator Cuff Tears
Partial rotator cuff tears are often painful and your arm may be weak or unable to be raised. Tests such as the empty can test are used to confirm suspected rotator cuff tear injuries. Dr Gupta will be able to advise further after consultation.
Complete Thickness Rotator Cuff Tears
Complete rotator cuff tears are obvious as you will be unable to raise your arm at all. Additional movement tests such as reaching behind your back will determine the severity of your condition.
X-Ray and MRI are used to uncover the presence of boney spurs, and the severity, size and location of the suspected injury.
Early diagnosis and treatment of rotator cuff tear injury is extremely important to avoid risk of a more complex injury.
Treatment of Rotator Cuff Tear
Dr Gupta is an experienced Orthopaedic surgeon and consultant who has treated many types of patients suffering rotator cuff tear injury.
Treatment of a rotator cuff tear injury should always begin with a thorough diagnosis to understand the severity of the condition in the context of your age, your sport, your work and your life to understand what is important to you about your recovery.
Non Surgical Treatment
Partial thickness rotator cuff tear injuries may be treated non-surgically using;
- Pain and anti-inflammatory medication
- Physiotherapy treatment for improved strength, better posture and function
Full thickness rotator tears are indicated for surgery.
Single Row Repair
Operation which repairs a small full thickness tear
Double Row Repair
Operation which repairs a large full thickness tear
Post Operative Rehab Protocol
Dr Gupta uses a proven rehabilitation process for each of his operative procedures. Find out more about our rehab here at our Rotator Cuff Repair Protocol Page.
Dr Gupta understands rotator cuff tear injuries in the context of sports, work and aging and can provide you with the very best diagnosis and treatment for your condition.
For bookings, please call 02 9687 9344, or make an online booking to secure an appointment with a professional.