What are the symptoms of a rotator cuff tear? Sudden tears from accidents cause immediate, intense shoulder pain and arm weakness. With degenerative tears, you may have mild pain that improves with over-the-counter pain relievers. Over time, the pain gets worse, and pain relievers don't help.
The main symptom of a torn rotator cuff is pain. If the tear happens suddenly, the pain will start immediately and be severe. You may also feel a pop or a snapping sensation with immediate weakness. If the tear develops over time, the pain can be mild and gradually get worse.
Some partial rotator cuff tears may go unnoticed because they don't always cause pain. A condition called frozen shoulder can sometimes mimic the symptoms of partial rotator cuff tears. Treatment is not necessary if there is no pain associated with the partial rotator cuff tear.
Rotator cuff tears may occur in two ways: A sudden acute tear may happen when you fall on your arm while it is stretched out. Or, it can occur after a sudden, jerking motion when you try to lift something heavy. A chronic tear of the rotator cuff tendon occurs slowly over time.
Patients still have the ability to raise their arm, and they can still do day-to-day things, but they tend to have some pain. So, being able to use the arm and move it and raise it above your head does not necessarily mean that the rotator cuff is intact.
Red flags include: Trauma, pain and weakness, or sudden loss of ability to actively raise the arm (with or without trauma): suspect acute rotator cuff tear. Any shoulder mass or swelling: suspect malignancy. Red skin, painful joint, fever, or the person is systemically unwell: suspect septic arthritis.
A rotator cuff strain is a stretching or micro-tearing of the tendons and muscles surrounding the shoulder joint while a tear is a complete or partial tearing of one or more of the tendons in the shoulder.
An injury to your rotator cuff usually causes pain, weakness, stiffness, loss of flexibility or range of motion, and loss of function in severe cases. If you feel any sort of pain or find it difficult to complete everyday tasks, you should seek medical care right away.
Injury to the rotator cuff causes shoulder pain, which can be either acute or chronic. A jarring motion like a sudden blow to the shoulder can cause acute pain. Chronic pain can arise from a job that requires constant lifting and reaching overhead, or a sport that requires constantly winding the arm.
The drop arm test is used to assess for full thickness rotator cuff tears, particularly of the supraspinatus. This can be useful when diagnosing sub-acromial pain syndrome (shoulder impingment) or to differentiate between shoulder and rotator cuff pathologies.
Typically, you will feel pain in the front of your shoulder that radiates down the side of your arm. It may be present with overhead activities such as lifting or reaching (e.g., serving in tennis, painting a ceiling). You may feel pain when you try to sleep on the affected side.
Symptoms of a Torn Rotator Cuff
Swelling around your shoulder will happen within a few hours after the injury or in the following days. If the injury is severe enough, you may also have some bruising on your shoulder. Immediate, intense, pain will follow – especially when you try to raise, lower, or rotate your arm.
The special tests described in this review evaluate specific tendons of the rotator cuff. The Jobe's test and drop arm test evaluate the supraspintus whereas the lift-off test, passive lift-off, and external rotation lag signs assess the infraspinatus and teres minor.
This rubbing against the tendon is called rotator cuff impingement. Impingement can be diagnosed without an imaging test, by the physical exam of an experienced doctor, but can also be directly diagnosed on live ultrasound while moving your arm.
Patients are often advised to wear a sling or brace for the first 4–6 weeks after rotator cuff repair surgery to prevent them from performing any physical activities involving the affected shoulder (3).
There are three stages of rotator cuff injury. The first stage is tendinitis, a simple inflammation of the rotator cuff, which can be painful but is relatively simple to treat. The second stage is tendinosis, in which the tendons of the rotator cuff start to degenerate. The third stage is a tear of the rotator cuff.
Irritation of the partially torn tendon can cause mild to severe pain, depending on the size of the tear and the amount of irritation it causes in the tissue around the tendon. The goal of treating a partially torn rotator cuff tendon is to allow the irritation of the tendons and the bursa around the tendons to cease.
Usually, mild rotator cuff tears or sprains will heal within four weeks. In other severe cases, the recovery might take 4 to 6 months or even longer based on several factors such as the severity of the tear, age, and other health complications.
MRI and US Diagnostic Accuracy in Primary Rotator Cuff Tears
MRI and ultrasound (US) have classically been accurate tools for detecting primary full thickness tears.
Grade 0 represents a normal rotator cuff, grade 1 is superficial fraying less than 1 cm in size, grade 2 involves fraying 1 to 2 cm in size, grade 3 is tissue disruption in 2 to 3 cm of tendon, and grade 4 is a substantial cuff tear that involves a sizable flap and more than one tendon.
Delaying treatment of a torn rotator cuff can increase the risk of the shoulder sustaining even more damage because the tendons and muscles cannot heal properly. The overused muscles will start fraying, and additional tears can develop.
Over time, there may be pain at rest or at night, such as when lying on the affected shoulder. You may have weakness and loss of motion when raising the arm above your head. Your shoulder can feel stiff with lifting or movement. It may become more difficult to place the arm behind your back.