One of the most common causes of shoulder painpainAn unpleasant sensation associated with actual or potential tissue damage, and mediated by specific nerve fibe... is the result of a torn rotator cuffrotator cuffThe rotator cuff is made up of four muscles and their tendons. These combine to form a "cuff" over the head of....

The rotator cuff is made up of 4 muscles. Their tendonstendonsFibrous bands, one at each end of a muscle, that connect the muscle to bones. form a "cuff" of tissuetissueA collection of similar cells and the intercellular substances surrounding them. over the upper end of the arm boneboneThe hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst... (humerushumerusThe bone of the arm, articulating with the scapula above and the radius and ulna below.)—the rounded "ball" at the top of the ball and socket jointjointThe junction or articulation of two or more bones that permits varying degrees of motion between the bones.. The space between the rotator cuff and the shoulder blade (scapula) is cushioned and lubricated by bursae.

The rotator cuff helps move the arm in a circular fashion, such as when:

• swimming
• throwing a ball
• lifting an item overhead
• putting on a jacket

One of these muscles (called the supraspinatus) rests on top of the shoulder. Its tendontendonA tough, rope-like cord of fibrous tissue at both the origin and insertion of muscle. travels under the shoulder blade, on the outside of the shoulder—a position that makes it vulnerable to injury. The injury can lead to inflammationinflammationA local response to injury due to a physical reaction (such as abrasion), or to chemical or biological agents,... of the tendon (tendinitis) or the nearby bursae (bursitis).

Torn rotator cuffs also are associated with what is called shoulder impingement syndrome, a squeezing or pinching of the rotator cuff.

Sometimes a rotator cuff tears completely. In other cases, there is only a partial tear.

what causes a torn rotator cuff? who is at risk?

As we age, the tissue quality of the tendons weakens, making them more likely to tear. That's why rotator cuff tears are seen in older patients.

Repeated lifting or sports activities that require overhead movements also can cause a torn rotator cuff. Rotator cuffs may also tear when you fall on an outstretched hand or collide hard with something.

Sometimes arthritisarthritisJoint inflammation can be associated with a torn rotator cuff (rotator cuff arthropathy). This happens when a rotator cuff has been torn for a long time and the shoulder has not been working properly.

what are the symptoms of a torn rotator cuff?

Normally a person with a torn rotator cuff will feel pain over the top and outer side of the shoulder. The pain may radiate down the arm. This is more obvious when the arm is raised or extended, or when it‘s lowered to the side after the shoulder has been moved backward and the arm raised.

Simple tasks like getting dressed can be painful. Sleeping may be difficult. The shoulder may also feel weak. Sometimes there is a "popping" sound when it moves.

Sometimes the pain is sudden and severe, especially after an injury. Other times it may be mild and occur only when the arm reaches overhead.

how is a torn rotator cuff diagnosed and treated?

Doctors will take a thorough medical history and examine the shoulder. Doctors also may suggest an MRIMRIShort for magnetic resonance imaging. This is a special radiologic test that allows for excellent imaging of t... to distinguish between a fully torn and a partially torn rotator cuff. Doctors may recommend that patients treat their torn rotator cuff with rest, heat, or cold to the affected area, and pain/anti-inflammatory medications.

Other treatment options may involve using a sling, to rest the shoulder. The doctor and physical therapist may propose a plan of strengthening exercises to improve mobility, strength, and function. The doctor may also suggest a consultation with an orthopaedic surgeon that specializes in shoulders for advice.

If the patient and surgeon decide on surgerysurgeryThe branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipula..., the surgeon can advise whether an arthroscopy can be performed. This form of minimally invasive surgeryminimally invasive surgerySurgery requiring small incision(s), usually performed with endoscopic visualization. allows the orthopaedic surgeon to see inside the shoulder and to carry out procedures through tiny incisions in the shoulder.

Doing rotator cuff repair arthroscopically means surgeons can make small "poke" holes through the muscle and work deep in the shoulder. As a result, experts point out, patients have much less pain post surgery and a faster recovery.

If the rotator cuff tear has advanced to an arthritic condition (rotator cuff tear arthropathy), the surgeon may suggest shoulder replacement.

learn more about arthroscopy surgery

what can patients expect long-term?

The success of rotator cuff treatment involves many factors, including compliance with any suggested physical therapyphysical therapyThe treatment consisting of exercising specific parts of the body such as the legs, arms, hands or neck, in an..., the patient‘s age, overall health and the severity of the condition.