Types of Injuries That May Lead to a Rotator Cuff Tear:
- Acute Injury: Caused by sudden onset trauma such as a car accident, lifting a heavy object improperly or falling on your outstretched arms.
- Chronic Injury: Caused by slow wearing down of shoulder structures due to repetitive stress, such as rowing, tennis or a physically repetitive job like painting.
- Degenerative Injury: Like any structure in the body, rotator cuffs lose their vitality as we age. Degenerative injuries can be made worse by repetitive stress, lack of blood supply and bone spurs, which also occur with age.
- Tendonitis: When a tendon becomes irritated or inflamed because of over-use, pain associated with tendonitis will usually follow. Tendonitis of the shoulder is especially common in swimmers and baseball players.
- Bursitis is when your bursa, a small fluid-filled sac protecting your rotator cuff, becomes irritated. It may occur when you repeat the same movement over and over again, such as lifting something over your head or throwing a football. An infection can also cause bursitis.
- Shoulder impingement is a common reason for shoulder pain and occurs when your rotator cuff catches or rubs on your shoulder bones. It leads to persistent pain as your tendons become injured and start swelling. If not treated, shoulder impingement can cause a rotator cuff tear.
Types of Rotator Cuff Tear:
- Partial rotator cuff tears: This is a damaged rotator cuff tendon, but it’s not torn all the way through. This is also called a partial thickness tear.
- Complete rotator cuff tear: This is when you have soft tissue that tears into two different pieces. Often, the tendons tear away from the upper arm bone. A full thickness tear doesn’t heal by itself since your muscles pull the tear’s edges apart. But, it is possible for a partial or full thickness tear to stabilize and leave your shoulder with reasonable function and comfort.
- Acute tear: Trauma or injury causes these tears. For instance, if you lift a heavy object too awkwardly or quickly, you could tear your rotator cuff. Similarly, if you encounter a fall involving an outstretched arm, you could have an acute tear. Shoulder injuries, such as a dislocated shoulder or broken collarbone, can also cause an acute rotator cuff tear.
- Degenerative tear: Many rotator cuff tears occur from a slow wearing down of your tendon and have multiple origins. Genetics and specific health conditions like high cholesterol and diabetes can also cause them too. Because of this, your dominant arm will is more likely to get a rotator cuff tear because you tend to use it more, and it experiences repetitive stress. Degeneration also naturally occurs as you age, increasing your chances of injury over time.
Diagnosing Your Shoulder Injury
Getting a correct and thorough diagnosis is essential to proper healing. This starts with great imaging. Dr Paley may order X Rays, an MRI or an ultrasound to make sure that we understand the full scope of your shoulder injury before formulating a treatment plan.
Non-Surgical Treatment Options
- RICE – Rest, Ice, Compression and Elevation – is the easiest and cheapest way to heal your injury. To read more about how to RICE properly, head over to our blog post, here > https://daytonorthopedicsurgery.com/2020/01/26/r-i-c-e-treatment-plan-for-injured-or-painful-joints/ . The doctor might recommend rest and limiting overhead activities. They might also prescribe you a sling to keep your shoulder still and protect it.Nonsteroidal anti-inflammatory drugs (NSAIDs): Medication, like naproxen and ibuprofen, reduce swelling and pain.
- Activity modification: Avoid shoulder pain-causing activities.
- Steroid injection: If standard medications, rest and physical therapy don’t help relieve your pain, a local anesthetic injection and cortisone preparation could help. Cortisone is typically an extremely effective anti-inflammatory medication, but it’s not useful for everyone.
- Physical therapy and strengthening exercises: Specific exercises can help strengthen your shoulder and restore movement. The exercise program will likely include stretches for improving range of motion and flexibility. Strengthening your shoulder-supporting muscles can prevent further injury and relieve pain.
- PRP & Stem Cell Shots: Using your body’s own healing components to hyper-charge tissue regeneration, PRP & Stem Cell Shots offer the cutting edge in medical science. For more information on regenerative medicine, please visit our dedicated page, here: https://daytonorthopedicsurgery.com/2019/12/17/living-pain-free-stem-cell-therapy/
Although doctors typically recommend prompt surgery for acute cuff tears in healthy shoulders, certain exercises could help maintain strength and flexibility of joints with long-standing tears. Usually, you can perform these exercises from your home with little to no specialized equipment. They’re best performed gently and a few times daily. These exercises are not dangerous if you perform them gently, so there’s no risk of enlarging the rotator cuff tear.
Surgical Rotator Cuff Tear Repair Options
Dr Paley may suggest surgery if there’s no improvement in your pain with nonsurgical treatment methods. Persistent pain is the primary indication for surgery. A physically-demanding job or desire to resume normal activity quickly, without the sometimes extensive rest needed to heal naturally, may also impact your doctor’s decision.
Other indications surgery could be a better option for you are:
- Your tear is large — over 3 cm — and the surrounding tissue quality is good.
- Your symptoms have lasted six to 12 months.
- A recent, acute injury caused your tear.
- You’re experiencing a substantial loss of function and weakness in your shoulder.
Surgical repair of a torn rotator cuff usually involves the surgeon re-attaching your tendon to the head of your humerus. Several options of rotator cuff tear repair exist. Dr Paley will sit down with you and talk about the best surgical procedure that will be most suitable for your case.