What is a rotator cuff tear?
Rotator cuff tear and strain are the same. These terms are used to describe inflammation in the cuff tendons or muscles.
The rotator cuff tendon(s) may tear due to an injury, chronic tendinopathy, or both. This could be due to a fall, rapid use of force or a direct blow.
A sudden acute tear may occur when you fall on your arm while it is stretched out. Conversely, it can occur with a quick, jerking move when lifting a heavy object.
Rotator cuff injuries are common in athletes who engage in overhead sports (such as baseball, tennis, and swimming) and in older adults who may experience degenerative changes in the shoulder joint.
A chronic rotator cuff tear develops gradually over time. You are at greater risk if you have persistent tendinitis or impingement syndrome.
There are two types of rotator cuff tears:
- A partial tear occurs when the attachments to the bone are not entirely severed.
- A complete, full-thickness tear indicates that the tendon has been completely compromised.
Rotator cuff tear vs frozen shoulder
Frozen shoulder and rotator cuff tear exhibit similar symptoms. However, the differentiating sign between a frozen shoulder and a rotator cuff tear is how the shoulder moves.
A frozen shoulder limits the range of shoulder motion for the patient. As a result, when the doctor attempts to move the arm, it may not move beyond a specific point.
On the other hand, in the case of a rotator cuff tear, the patient can lift his hand manually beyond specific points even though he might experience difficulty and pain.
Rotator cuff tear symptoms
Some people have few or no symptoms of rotator cuff tear. However, here are some of the common symptoms:
- Pain in the shoulder region
- Specific muscle-tendon unit weakness
- Popping sounds when you move your arm
Rotator cuff tear diagnosis
Your doctor would first question your general health and symptoms before conducting a thorough physical examination. Diagnosis is made based on your reported symptoms, physical examination, and investigations.
In most cases, radiographs and other imaging studies are not required to identify rotator cuff tears. However, if the patient's symptoms do not improve following conservative treatment, an imaging test (ultrasound or magnetic resonance imaging (MRI) may be advised.
Rotator cuff tear diagnosis treatment options
The rotator cuff tear will worsen over time if it is not treated. The symptoms might aggravate chronic inflammation, intense pain, loss of strength, and range of motion, making it difficult to perform daily tasks.
The treatment of rotator cuff injuries focuses on reducing tendon discomfort and swelling, preserving, or regaining a normal range of motion, strengthening shoulder muscles, and restoring normal shoulder mechanics.
In many individuals, a diminished ability to move the shoulder results in less frequent usage of the joint, which can further decrease the range of motion and develop into a frozen shoulder.
- Rest: Avoid activities that may aggravate symptoms. Avoiding painful activities will alleviate pressure on the affected area.
- Physiotherapy: Several physical exercises help strengthen your shoulders and restore natural movement. For example, stretches help to relieve the pain and regain flexibility.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are commonly prescribed to reduce pain and swelling.
- Surgery: Surgical repair of a torn rotator cuff depends on your age, activity level, and the severity of the tear. It is usually recommended for those with complete rotator cuff tear, particularly if the patient is active and /or young. There are two ways to repair the rotator cuff: open or arthroscopically.
Rotator cuff tear exercises and tips
The prime goal of the exercises is to improve flexibility and strength on targeted muscles. The following are some exercises that you may perform under the guidance of your doctor/physiotherapist.
- 1. Crossover arm stretch
- Gently relax your shoulders and pull the injured arm across the chest as far as possible while keeping the upper arm in a holding position.
- Hold your arm in this position for about 40 seconds and gently relax.
- Repeat this exercise 4 to 5 times on each arm.
- 2. Internal rotation
For this exercise, you will need an elastic band with comfortable resistance.
- Take a stretch band and make a 3-foot-long loop. Attach the loop to any stable object while tying the ends together.
- Stand holding the band with your elbow bent and at your side.
- Bend your injured elbow at a 90-degree angle and rotate the arm inwards toward your body.
- Return to the initial position and repeat 10 to 12 times.
- 3. External rotation
You will need an elastic band for this exercise as well.
- Tie the ends of elastic bands together after making a 3-foot loop.
- Attach the elastic band to any stable object (you could even choose your doorknob).
- Stand while holding the band.
- Keep your elbow bent and close to your side.
- Gently rotate your arm outwards.
- Return to your initial position and repeat.
- Repeat the exercise 5 to 8 times.
- 4. Pendulum swing
- Lean forward with one hand on a table for support while letting the other arm hang freely.
- Gently swing your arm backwards and forwards like a pendulum.
- Repeat this exercise by moving your arm in a circular motion and moving it from side to side.
- 5. Sleeper stretch
- Lie on a flat, firm surface by keeping your affected shoulder below you while bending your arms. If required, you could use a pillow for comfort.
- Use your healthy arm to push your affected arm down. Stop pressing when you can feel tightness in the back of your affected shoulder.
- Maintain this position for about 10 seconds and gently relax.
- Repeat this exercise 5-10 times each session.
- 6. Elbow extension
- Stand erect to ensure your weight is evenly distributed over both feet.
- Raise your arm and bend your elbow.
- Place the opposite hand on your arm to get support.
- Gently straighten your elbow and bring it overhead.
- Gently lower your arm back behind your head.
- Repeat the whole process 8-10 times.
- 7. Posterior capsule stretch
- Hold the elbow of the injured arm firmly.
- Slowly pull it across the chest to stretch the back of your shoulders.
- Make sure to keep your shoulder blades depressed (to avoid pinching the front of your shoulders).
- Hold this position for 30 to 40 seconds.
- Repeat the movement 2-3 times.
- 8. Internal and external rotation
- Lie on your back on a flat surface.
- Bend your elbows at right angles while extending your arms straight out.
- Keep the fingers pointed up.
- Keep your elbows bent and on the floor.
- Gently move your arms in an arc.
- If you feel pain at 90 degrees, bring your elbows down at 45 degrees.
- Repeat the entire exercise 8 to 10 times.
Exercises to avoid
There are some exercises and activities which could aggravate your rotator cuff tear and it is, therefore, suggested to avoid them.
- Any exercise with heavy weights.
- Holding your arm in an awkward position.
- Turning, twisting, or rotating your arm.
Book an appointment at Gleneagles Hospitals
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Get in touch with us to book an appointment with an Orthopaedic specialist or the team of physiotherapists and clinical rehabilitative team specialists at Gleneagles Hospital today.