Rotator Cuff Tears

Rotator cuff tears are tears of the tendons.  You can think of these as ropes that connect the muscles of the rotator cuff to the upper arm bone (humeral head) .  Tears are classified based on their size, location, and severity.

• Partial tears are incomplete tears of the tendon. They may be small or large. They damage the soft tissue, but the tendon remains attached to the bone.
• Full-thickness tears, also called complete tears, consist of the tendon completely detaching from the insertion. Complete thickness tears can occur anywhere along the tendon or detach the tendon from the bone. They may be acute or chronic, depending on whether the tear occurred suddenly or developed over time.
• Massive tears occur when two of the four tendons that make up the rotator cuff are entirely torn and retracted.

Rotator cuff tears can be caused by a variety of factors, including:

• Age: As we age, the tendons in our rotator cuff become weaker and more prone to tearing. These degenerative tears occur from normal wear and tear and typically occur in the dominant arm. The risk of a degenerative tear increases with age.
• Overuse: Repetitive overhead motions, such as those used in baseball, tennis, rowing, weightlifting, or swimming, can cause small tears in the rotator cuff tendons over time that may eventually cause the tendon to partially or completely tear. Certain jobs, such as construction, painting, and routine chores can also cause these tears.
• Trauma: A fall, motor vehicle accident, or other trauma can cause a sudden tear in one or more rotator cuff tendons.
• Impingement: When the rotator cuff tendons become pinched or compressed between the bones in the shoulder joint, it can cause them to fray or tear.

The symptoms of a rotator cuff tear can vary depending on the severity of the tear, but may include:

• Pain: The most common symptom of a rotator cuff tear is pain in the shoulder, especially when lifting or moving the arm. The pain may be a dull ache in the shoulder that progressively worsens with use. Often, the pain is severe and interferes with sleep.
• Weakness: A rotator cuff tear can cause pain and weakness in the shoulder, making lifting or carrying objects difficult.
• Limited range of motion: A torn rotator cuff can limit the range of motion in the shoulder, making it difficult to reach overhead or behind the back.
• Cracking or popping: Some people may hear cracking or popping sounds when moving the shoulder if they have a rotator cuff tear.

Shoulder surgeon Dr. Daniel Kaplan will review your medical history and ask about your symptoms and whether or how you injured your shoulder.  He will ask what motions elicit your pain and how your symptoms are affecting your life. He will perform a physical exam of your shoulder, checking for pain and weakness and testing strength and range of motion. He will order imaging tests, such as X-rays, to evaluate the bones and potentially an MRI to view the soft tissues. The MRI will allow him to evaluate the soft tissue structures inside your shoulder joint and determine the severity of the tear.