What is a rotator cuff tear?
The shoulder joint is the most flexible joint in the body. It’s made up of the humerus head and the joint socket. Compared to other joints such as the knee or hip, the shoulder joint is only loosely secured to the bones: muscles, tendons and ligaments, in conjunction with the joint capsule, are primarily responsible for the crucial task of stabilising the joint.
A special group of four tendons in total ensure that the joint is directed with strength and stability and, most importantly, that it’s centred. This group of tendons is called the rotator cuff because they lie on the humerus head like a cuff. The rotator cuff muscles that run from the shoulder blade to the humerus bone (the subscapularis muscle, the supraspinatus muscle, the infraspinatus muscle and the teres minor muscle) move the arm up and to the side, turn it outwards and inwards and stabilise the arm on the torso.
These tendons run directly around the joint along a narrow bony canal between the humerus head and shoulder cap. Wear and tear can occur over time, especially in the supraspinatus tendon, and this is unnoticeable at first. In extreme cases, a hole or tear in the tendon can occur. This also typically affects the supraspinatus tendon in particular.
How does a rotator cuff tear occur?
From falls to sports injuries and even heavy lifting, there are many causes behind a rupture of the rotator cuff, also known as a rotator cuff tear. While just around 5% of tendon tears in the shoulder joint occur as a result of an accident in younger patients, rotator cuff ruptures due to degeneration are much more common, making up approximately 95% of cases. In this instance, the tendons have already been damaged due to wear processes and have thereby lost some of their stability. Just a minor fall or forceful ordinary movement is enough to finally injure the already damaged tendons.
Rotator cuff tear: symptoms that are signs of this injury
Many patients with a rotator cuff tear report a dragging or stabbing pain in the shoulder region that can radiate to the neck area or even the hand. This pain is typically even more severe at night, restricting the ability to have a good night’s sleep. Losing tension in these muscles and the ability to automatically maintain posture leads to significantly reduced mobility. In particular, moving the arm forwards or to the side will no longer be possible. This has far-reaching consequences. Those affected are severely limited in their everyday life, so their quality of life is reduced. They can no longer handle everyday activities that seemed normal before, such as brushing their hair or carrying shopping bags, or they can only complete them with great effort.
What are the recommended treatments for a rotator cuff tear
Simply resting the shoulder and perhaps some physiotherapy should help. Your doctor may also suggest anti-inflammatories and stretching exercises. Corticosteroid injections can help bring down the inflammation and pain.
You might need surgery depending on how big the tear is and where it is. If the tear is relatively small it might be possible to repair using an arthroscope, which is a type of endoscope inserted into the joint through a small incision.