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Rotator Cuff Tear - How Did It Happen? and What Next?
The rotator cuff is the name for a group of four muscles that hold the top of the arm in place in the shoulder joint. If we didn't have them you would find your shoulder joint dislocating each time that you tried lifting anything. All four of these muscles are connected to the shoulder blade or scapula at one end and the upper arm or humerus at the other and surround the shoulder forming a cuff of muscle around the shoulder joint, which is how they got their name.
If one or more of these muscles gets torn you have a rotator cuff tear either through wear and tear or a knock or fall. One analogy I have heard is that of comparing the tendons of the cuff to a car tow rope. If you try pulling something that is too heavy the rope will tear or snap and if you have been using the same old tow rope for several years it can become frayed through use.
Cuff Tears sometimes come about through a sudden trauma. If, for example, you were to fall and put your arm out to catch yourself the sudden impact can tear the muscle. Lifting something that is too heavy could have the same effect but would cause a different type of damage as the load is likely to be added more slowly. The muscles and tendons can also just wear out through repeated use either through age or because a work or leisure activity over uses the muscle. Anyone who throws a baseball repeatedly is putting strain on these muscles. Any repetitive overhead action like painting can have teh same effect.
If you tear your rotator cuff you will experience specific symptom such as weakness in the arm, pain when doing certain movements, especially reaching up or behind you. The test for a rotator cuff tear will usually involve getting someone to gently push against the doctor's hand whilst mimicking these movements; this will usually result in pain confirming the diagnosis.
The therapy can vary depending on the age of the person and the severity of the tear. Short or small tears are easier to repair and will probably only need anti-inflammatory drugs and physiotherapy, whilst larger tears may involve corrective surgery to mend the tear or free up space for the inflamed muscle to move more easily reducing or eliminating pain altogether.
If you are younger when you have surgery the greater the success rate. As you get older the success rate of the procedure can drop to around 60%. It is sometimes worth considering what you see as a successful outcome. Obviously, if you are a serious sportsperson the ideal outcome would be a return to total fitness. On the other hand, if you lead a fairly sedentary lifestyle the aim may be to be able to carry out certain everyday tasks and movements pain free.
Rotator cuff tears come in a variety of shapes and sizes and consequently can vary quite considerably in treatment and prognosis. Physical Therapy will always be a part of any treatment but it needs to be rotator cuff specific exercises aimed at strengthening and exercising the group of muscles without making things worse.
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If you want to know how rotator cuff surgery can be avoidedthrough exercise check out my story at my blog
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