I’m having shoulder pain – Did I tear my rotator cuff?

Many patients present to our center with shoulder pain and are worried that they may have suffered a rotator cuff tear.  The rotator cuff is made up of the tendons from 4 muscles: supraspinatus, infraspinatus, teres minor, and subscapularis.  The supraspinatus tendon is the most commonly torn rotator cuff tendon.

Rotator cuff tears are very common with up to 20% of the general population reported to have a rotator cuff tear.  Rotator cuff tears tend to occur more commonly after the age of 50 and increase over time.  Historical data indicates that almost 50% of people in their 70s have a rotator cuff tear.  

Rotator cuff tears can be associated with shoulder pain, weakness, and trouble with reaching and overhead activities.  These tears can sometimes be associated with pain at night and sleep disturbance.  

There are two types of rotator cuff injuries – chronic or acute.  The most common type is a chronic tear, or one that occurred gradually over time due to “wear and tear.”  Usually a patient cannot pinpoint a specific date of injury, the pain just started gradually.  

Acute rotator cuff tears are not so subtle.  These tears are often associated with a traumatic injury. Ultimately, rotator cuff tears can be diagnosed with a thorough history and physical examination.  The findings are then typically confirmed with magnetic resonance imaging (MRI).

Rotator cuff tears can sometimes be successfully treated without surgery.  Anti-inflammatory medications, activity modifications, and physical therapy exercises may help to relieve pain and restore function without surgery.  Rotator cuff tears that do not respond to non-surgical measures and larger rotator cuff tears with associated weakness can respond to surgical treatment.  Newer surgical and anesthesia techniques may help to decrease pain and improve recovery following rotator cuff surgery.