A rotator cuff is a group of four muscles that come together to attach the humerus to the shoulder blade. A torn rotator cuff tear is a common cause of shoulder pain in adults that may weaken your shoulder and cause many daily activities to become difficult and painful to accomplish.
If one or more rotator cuff tendons are torn, they can become completely detached from the head of the humerus. The most common tear is to the supraspinatus tendon, although other tendons may also become torn. Tears may be partial or full-thickness. If a tendon is completely detached from the bone, it is referred to as a full-thickness tear. These tears may be acute (from an injury) or chronic (related to wear and tear over time). Most often they occur as a result of normal aging and are therefore more common in those over the age of forty.
Common symptoms include:
- Pain at night
- Pain when lifting or lowering your arm
- Weakness when lifting
- A crackling sensation (also known as crepitus)
In as many as 85% of patients, nonsurgical treatment relieves the pain and improves function of the shoulder. This non-surgical treatment may involve rest, activity modification, steroid injection, and physical therapy. Surgery may be recommended if the tear is large, there is significantly reduced function in the shoulder, or the symptoms have lasted for over six months. In a rotator cuff repair, the tendon is re-attached to the head of the humerus. This can often be done arthroscopically but may be done in a traditionally open surgery if the tear is large.