If left untreated, a rotator cuff tear can severely restrict function and range of motion. The tear can also increase over time. This may cause partial rotator cuff tears to progress to total tears.
Without any treatment—either rest and rehabilitation or surgery—rotator cuff disorders may get worse. Over time, you may have more pain. You may lose range of motion and strength in your shoulder, making it harder to do your daily activities.
Even though most tears cannot heal on their own, you can often achieve good function without surgery. If, however, you are active or use your arm for overhead work or sports, surgery is most often recommended because many tears will not heal without surgery.
It takes six to eight weeks for the tendon to heal to the bone. Complete recovery time varies by size of the tear. For a small tears, full recovery time is about four months, for large tears, six months. For severe, massive tears, a complete recovery can take anywhere from 6 to 12 months.
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.
Your doctor uses imaging tests to help diagnose a rotator cuff injury. An X-ray helps to rule out bone spurs or osteoarthritis as a cause of your symptoms. An MRI scan enables your doctor to see the soft tissue in the shoulder and determine if you have a rotator cuff tear and whether it is partial or full thickness.
It is very uncommon to operate on a partial rotator cuff tear. In cases of deep partial tears — when more than 90 percent of the tendon is torn — surgery is recommended only if the symptoms can't be controlled with nonsurgical treatments. Specializing In: Sports Injuries to the Shoulder.
Rotator cuff tendon tears often cause pain at night. The pain may even wake you. During the day, the pain is more tolerable, and usually only hurts with certain movements, such as overhead or reaching toward the back. Over time, the symptoms become much worse and are not relieved by medicines, rest, or exercise.
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).
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.
Shoulder pain related to the rotator cuff (RC) is one of the most common and bothersome musculoskeletal complaints. Pharmacologic treatment most often includes acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
If there is a tear in the rotator cuff, the tear will become larger and larger until the tendon disintegrates completely, the muscle degenerates (muscle fibres are changed into fat) and the shoulder joint is no longer able to function. At this stage, it is too late to repair the rotator cuff by tenosuture.
Delaying treatment for a torn rotator cuff will increase your likelihood of developing further damage to your shoulder. When the tendons and muscles are torn and are not allowed to heal (usually due to overuse of the shoulder), they tend to fray over time.
Other signs that surgery may be a good option for you include: Your symptoms have lasted 6 to 12 months. You have a large tear (more than 3 cm) and the quality of the surrounding tendon tissue is good. You have significant weakness and loss of function in your shoulder.
The symptoms are usually aggravated by raising the arms overhead or in activities that require reaching behind the body, such as retrieving an object from the back seat of a car. Furthermore, reaching behind the back to fasten underclothing or to pass a belt may aggravate the arm and shoulder pain.
Rotator Cuff Repair surgeries are notoriously painful! Many patients say it is the worst pain they have ever experienced. To make matters worse, you are bound up in a sling after surgery and can't move the arm to try to “find a comfortable spot”.
Massive rotator cuff tears are typically defined as rupture of at least two of the four rotator cuff tendons and/or retraction away from the attachment site of 5 cm or greater. Thus, these are generally accepted as more challenging repairs with a longer recovery.
Age. The risk of degenerative rotator cuff tears increases with age, becoming more common after age 35. However, people age 60 and over are more likely to develop degenerative rotator cuff injuries as the muscles succumb to repetitive use over time.
A rotator cuff tear may be partial or complete. A partial tear is when one of the tendons of the rotator cuff is frayed or damaged. A complete tear (also called a full-thickness tear) is when the tendon in is severed in half or pulled completely off of the bone.
MRI is the best imaging test to evaluate the rotator cuff tendons because of the soft tissue contrast. This means that the tendons can be easily identified from the surrounding muscles and bones. A tendon tear will alter the normal MRI appearance, leading to the diagnosis.
Yes. Typically, the pain starts as a dull aching pain in your shoulder. As the injury progresses, it can cause radiating pain down the arm and into your hands. As a result, a person can lose the ability to raise their arm at all.
In this test you begin by placing the injured arm behind your back, with the back of your hand resting on you lower back. Now try to raise your arm off of your back.. If you feel pain or weakness when trying to lift your hand off of your back, that is a sign that there could possibly be rotator cuff injury involved.