Rotator Cuff Tears: More Common Than You Think

Author: Eric Bava, MD Orthopedic Surgeon, Sports Medicine MarinHealth Medical Network

As both athletes and sports fans know, the glory of sports comes with the very real risk of injuries. From torn ACLs to concussions, injuries are part of the game and recoveries can range from a temporary timeout to a season on the sidelines.

Among the sports injuries, shoulder impairments, including dislocations, muscle strains and ligament sprains, are among the most common. That’s because the shoulder is subjected to a wide range of motion and force during sporting activities.

Baseball players, tennis players and swimmers are especially susceptible to one of the most common shoulder injuries—a tear to the rotator cuff.

The rotator cuff consists of four muscles and tendons that form a covering around the top of the arm that attaches it to the shoulder blade. This group of muscles and tendons keep the ball of the joint in the shoulder socket and also provides the strength and movement to lift and rotate your arm and guide the movements of your wrists and hands.

Two types of injuries can occur to the rotator cuff: a complete or full-thickness tear, in which the tendon is completely detached from the bone, and a partial tear, in which the tendon is damaged but not completely severed.

Athletes aren’t the only ones susceptible to rotator cuff tears. People whose occupations involve repetitive shoulder movements, such as painters, window washers, and carpenters, are also susceptible. Even routine household chores like hanging pictures, dusting ceiling fans, or gardening can strain the rotator cuff when performed repetitively over time.

One surprising fact about rotator cuff injuries is that age is the number one risk factor. Most such injuries occur in people over age 40, with injuries occurring five times more frequently in people over 60. More than two million Americans seek medical help each year for a rotator cuff problem.

As we age, all the shoulder motions we have done over time—especially the repetitive ones—can cause the tendons in the rotator cuff to degenerate, often causing a partial tear. Age related risk factors also include a decrease in blood supply that can work to repair tendon damage, as well as the development of bone spurs that rub on the tendons, causing wear and frequently leading to an actual tear.

What are the symptoms of a rotator cuff tear and when should you seek help?

As you might expect, intense pain and immediate weakness are the results of tears that happen suddenly, such as from sports injuries, falls, or accidents.

For aged-related rotator cuff injuries, however, the most common symptoms are pain and arm weakness. You may notice shoulder pain when lifting your arm over your head, or even when combing your hair or getting dressed. Your arm feels weak and not up to lifting things or supporting your weight when you get up from a chair.

Pain medication may have helped at first, but you then notice the pain is there even when you are resting or sleeping, especially when lying on the affected shoulder. In some cases, a rotator cuff tear doesn’t cause pain, but will cause weakness in the arm.

Many people attribute aches and pains to getting older. In the case of a rotator cuff tear, however, if you keep using your shoulder and arm despite increasing pain, further damage such as a larger tear can occur.

If you are experiencing chronic shoulder and arm pain, make an appointment to see your doctor. A head start on diagnosing and initiating treatment for a possible tear can prevent symptoms from getting worse and minimize interruptions to your daily routines.

In addition to discussing your symptoms and examining your shoulder, arm, and neck areas, your doctor will likely order an X-ray followed by an MRI or ultrasound to confirm the diagnosis or rule out a tear.

Doctors have several treatment options for a rotator cuff tear, and as is the case with many injuries or medical conditions, the best option is different for every person.

Stay tuned next month for part two of this article, when I’ll cover surgical and non-surgical treatment options for both partial and complete rotator cuff tears. I’ll also address exercises and other lifestyle measures you can employ to minimize your risk of a rotator cuff tear.