As you go through everyday life, the rotator cuff in your shoulder tolerates extensive wear-and-tear. And if you're involved in athletic activities, you place intense stress on these muscles, making you vulnerable to sports injuries that injure the rotator cuff and have a significant impact on your ability to return to the game.
No matter what causes your torn rotator cuff, the worst thing you can do is to put off getting medical care. The longer you keep using your arm, the more likely you are to turn a small tear into a major rupture.
Most people improve with nonsurgical treatment under the direction of orthopedic surgeon David Dickerson, MD at Performance Orthopaedics and Sports Medicine. However, a large tear or complete rupture may need his surgical skill to restore optimal strength and movement.
Causes of a rotator cuff tear
Your rotator cuff consists of a group of four muscles and their tendons. These tissues hold your upper arm in the shoulder joint while also supporting arm movement such as lifting and rotating.
An acute (sudden) injury such as falling on your arm or dislocating your shoulder can tear the rotator cuff. Age-related tissue degeneration can also lead to tears. However, overuse injuries most often cause a torn rotator cuff. This type of injury occurs when repeated arm movements place stress on one or more of the rotator cuff tendons.
Overuse injuries can occur in anyone but frequently affect athletes who engage in throwing sports, contact sports, and weightlifting. People whose job requires repetitive overhead movement such as painters also have a higher risk of developing a rotator cuff injury.
Overusing the tendons causes tiny tears. If you rest and give the tissues time to heal, you can avoid a more serious injury. With ongoing stress, however, these small tears enlarge, inflammation develops, and you eventually end up with a complete rupture.
Signs of a torn rotator cuff
These are five signs that you may have a torn rotator cuff:
In many cases, but not all, pain is the first sign of a torn rotator cuff. If an acute injury causes the tear, you experience immediate and usually severe pain. But when your rotator cuff tear develops gradually, the initial pain is mild and typically occurs when you make certain arm movements — for example, when you lift or lower your arm, carry heavy objects, or reach overhead.
The pain often occurs in the front of the joint. It can also radiate down the outside of your shoulder. Many people have pain when lying on the side with the injured shoulder.
As you keep using the damaged rotator cuff and more damage occurs, the pain gets progressively worse. Without treatment, the pain gets severe enough to stop you from engaging in daily activities.
Even if you don't experience pain — and some people don’t — a rotator cuff injury affects arm movement. When you tear the rotator cuff, the injury usually affects one or more of the tendons that connect the muscles to the top of your upper arm. Because these tendons move your arm, a tear limits the arm's range of motion.
An acute injury can dramatically interfere with movement, while an overuse injury results in limited movement that gradually worsens. You may have trouble raising your arm, reaching behind your back, and lifting items.
Muscle weakness and atrophy
When a rotator cuff injury goes untreated, the affected muscles weaken and atrophy (waste away). The muscle weakness affects your shoulder and your arm. The extent of the atrophy depends on variables such as your age and the size of the tear. As muscle degenerates, it becomes more difficult for the muscles to heal and regain optimal strength after surgical repair.
Swelling and tenderness
If you have a partial rotator cuff tear, the inflamed tendon may cause swelling and tenderness to the touch.
Crepitus refers to popping and clicking sounds and sensations that occur in the shoulder joint when you move your arm. Though other shoulder conditions like bursitis can cause crepitus, the problem also arises when a torn ligament forces the bones in the joint off track or out of alignment.
Are you having shoulder problems?
If you experience shoulder pain, limited arm movement, or muscle weakness in your arm or shoulder, don't wait to schedule an evaluation. Call Performance Orthopaedics and Sports Medicine or book an appointment online today.