Rotator Cuff Tears

There are two main types of causes: acute injuries and degenerative changes.

• Acute tears often happen from a sudden movement or accident. This can include lifting something too heavy, falling on an outstretched arm, or trying to catch yourself during a fall. Athletes and people with physically demanding jobs are more likely to experience this type of injury.
• Degenerative tears are more common and develop over time. As we age, the tendons in the shoulder naturally weaken and become less flexible. Repetitive motions, such as lifting, reaching overhead, or certain sports like tennis or swimming, can gradually wear down the tendon. Poor posture and bone spurs can also contribute by putting extra pressure on the rotator cuff.
• Risk factors include over age 40, smoking, and jobs that involve repeated shoulder use, such as construction work or painting.

The symptoms can vary depending on the severity of the tear, but there are several common signs including:

• Pain is usually the first symptom. It may be felt deep in the shoulder and can worsen when lifting your arm, reaching overhead, or lying on the affected side. Some people notice pain at night that disrupts sleep.
• Weakness in the shoulder is another key symptom. You may find it harder to lift objects, raise your arm, or perform routine tasks like brushing your hair or reaching into a cabinet.
• Limited range of motion is also common. Your shoulder may feel stiff, and certain movements may be difficult or impossible.
• Some people experience a clicking or popping sensation when moving the shoulder. In more severe cases, there may be a sudden loss of strength after an injury.

It is important to note that some rotator cuff tears, especially small or gradual ones, may cause only mild discomfort at first. However, symptoms often worsen over time if left untreated.

Diagnosis begins with a detailed medical history and physical exam. Your doctor will ask about your symptoms, when they started, and what activities make them better or worse. They will also examine your shoulder to check for pain, weakness, and range of motion. During the physical exam, you may be asked to move your arm in different directions or resist gentle pressure. These tests help identify which tendon may be affected.

Imaging tests are used to confirm the diagnosis. X-rays can show bone changes, such as spurs, but they do not show soft tissues like tendons. For a clearer picture, your provider may order an MRI or ultrasound. These tests can show the size and location of the tear and help guide treatment decisions. In some cases, additional tests may be used if the diagnosis is unclear or if other shoulder conditions are suspected.