The soft tissues (muscles, ligaments, and tendons) surrounding the shoulder joint are known as the rotator cuff. These tissues work together to keep your shoulder the most flexible joint in your body. However, that flexibility can come at a price: shoulder injuries are the most common form of joint damage sustained by human bodies.
Tears in the rotator cuff prevent you from doing what are otherwise easy activities, like lifting your arm or reaching overhead. The most common risk factors predicting the likelihood of developing a rotator cuff tear are age, some jobs, and family history.
There are a few telltale symptoms of rotator cuff tears. These symptoms can help you determine whether you are dealing with signs of a tear and would be vital towards your torn rotator cuff treatment.
Job Requirements
Some careers seem to cause rotator cuff tears more than others. Constructor workers and other workers whose jobs require them to use repetitive arm-lifting movements, such as painting, heavy lifting, or prolonged vibration like those who use jackhammers, are at a high level of risk for developing rotator cuff tears. One study found that twenty years of work with these requirements put workers at risk for a rotator cuff tear or another shoulder injury at a rate four times greater than workers in other fields. If your occupation requires you to lift your arms for extended periods of time or to repetitively lift heavy weights, and you begin to feel shoulder pain, it makes sense to suspect that you could be dealing with a rotator cuff tear.
Advanced Age
Rotator cuff tears are very common, especially as you age. Over 30% of adults aged 60 or older experience a rotator cuff tear, with that number doubling to 62% for adults over 80.
All of your soft tissues begin to lose their flexibility over time, and the muscles and tendons that keep your shoulder in its socket are no different. The less flexible these tissues are, the more vulnerable you are to injury, even from very minor incidents. There is also the possibility of sustaining a rotator cuff tear from improper use of mobility aids like canes and walkers.
In order to prevent this kind of injury from happening to you, you can do daily strengthening exercises. These exercises should focus not only on the shoulders and chest area, but also on the muscles in your back. A physical therapist can help you develop a routine that fits your lifestyle and ability best.
Recurring Pain
Pain in the shoulder is usually the first sign that something is wrong. This is especially true for rotator cuff injuries that develop over time, as is often the case with tears caused by overuse or repetitive movement. For rotator cuff tears, the pain will worsen with specific activities. You may also feel more pain when your arm is at rest. Many patients describe the pain as a deep, dull, constant ache. The pain may become sharper when you attempt to do activities that require more of the muscles that make up the rotator cuff, such as lifting an item or raising your arms overhead. You will have difficulty doing some everyday activities like brushing your hair.
Limited Range of Motion
Because the rotator cuff is so integral to the function of the shoulder joint, damage to the rotator cuff makes it difficult for you to move your shoulder in the ways you are used to. After experiencing an injury that caused trauma to the shoulder, you may notice that you are not able to move your shoulder as well or as flexibly as you usually do. Rotator cuff tears will especially contribute to difficulty lifting your arm overhead. You may not be able to raise it far at all.
Popping Sound
Patients with a rotator cuff tear often report a frequent popping or cracking sound when they move their shoulders. This sound is known as crepitus and can be an annoying symptom. This sound is caused by the misalignment of the ball and socket of your shoulder, causing cartilage and other tissues to rub against each other when normally the rotator cuff would allow a more smooth movement.
Muscle Weakness
Since rotator cuff tears affect the muscle, weakness in those muscles is a frequent side effect. You may find that your pain is manageable but that you have difficulty lifting even small, light items. Raising your arm overhead may feel impossible, and even just moving your arm a few inches from your body can be difficult.
Difficulty Sleeping
The constant pain of a rotator cuff tear could be enough to disturb your sleep pattern, but these difficulties may increase if your injury is in the shoulder that you usually sleep on. This problem is exacerbated by the tendency of rotator cuff injuries to worsen in pain when at rest. The pain people experience at night from rotator cuff tears is due partly to gravity. Lying down causes gravity to pull at the tendons in a way that can be better avoided during the day. Pain from the night before may also make your shoulder feel stiff in the morning when you awake.
Fortunately, treatment for rotator cuff tears is usually successful. Usually, all that is required are rest, icing, and physical therapy, and most people have a complete recovery. Of course, this depends on the severity of the injury. Some people may need more intensive medical attention. Some of the shoulder pain treatments your doctor may suggest include:
- Activity modification for the duration of your injury
- Pain management through the usage of over-the-counter medications, especially NSAIDs like ibuprofen and aspirin
- Steroid injection into your joint to help manage pain
- Physical therapy to help restore flexibility and strength or to further strengthen muscles to prevent recurring injury
- Surgery for recurring cases or for severe injuries
- Arthroscopic tendon repair with the aid of a very small camera
- Open tendon repair achieved through an incision
- Tendon transfer for severely damaged tendons
- Shoulder transfer for severe damage – these surgeries are much rarer than other treatment options