What are the other Names for this Condition? (Also known as/Synonyms)

• RC Tear
• RCT (Rotator Cuff Tear)
• RTC Rupture

What is Rotator Cuff Tear? (Definition/Background Information)

• A Rotator Cuff Tear (RCT) is an injury that occurs, when one or more muscles and tendons that help secure the shoulder joint tear
• Such tears are very painful and they result from any physical activity, such as an athletic sport, or a normal daily activity that may require repetitive use of the shoulder muscles
• Rotator cuff muscles are a set of 4 muscles that connect the upper arm to the shoulder blade. This helps in arm rotation and in lifting objects
• A majority of the Rotator Cuff Tears occur, when the supraspinatus muscle in the shoulder tears

Who gets Rotator Cuff Tear? (Age and Sex Distribution)

• Rotator Cuff Tears are more common in individuals over the age of 40 years. These non-specific injuries may occur in individuals of any gender, race/ethnic group
• Athletes, who participate in any sport that require a set of repetitive shoulder muscle movements, have a higher incidence rate

What are the Risk Factors for Rotator Cuff Tear? (Predisposing Factors)

Common risk factors associated with Rotator Cuff Tears include:

• Individuals over the age of 40 years; the risk increasing with age
• Highly stressful and repetitive activities that are related to sports and certain occupations

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Rotator Cuff Tear? (Etiology)

There are 4 main muscles that connect the upper arm bone (humerus) to the shoulder blade (scapula), which constitute the rotator cuff. These muscles include the subscapularis, supraspinatus, infraspinatus, and teres minor. Shoulder injuries involving the rotator cuff muscles are quite common; they also include any irritation to the muscles/tendons of the rotator cuff. A few causal factors associated with Rotator Cuff Tear include:

• Sports-related injury: Individuals participating in certain sports activities that require a set of repetitive movements for prolonged periods, such as baseball or tennis
• Sudden lifting or pulling: Use of a sudden force to pull or grab an overhead object can cause a shoulder muscle tear, by putting a tremendous amount of stress on the tissues surrounding the shoulder joint
• Fall injuries: A direct fall hurting the shoulder

What are the Signs and Symptoms of Rotator Cuff Tear?

The symptoms are usually mild at the beginning and do not warrant immediate medical attention. There could be a noticeable pain associated with any activities that involve lifting the arms above one’s head/shoulder. The signs and symptoms of a Rotator Cuff Tear include:

• Pain when extending the arm, or lowering the arm from a raised position
• Radiating pain from the shoulder to the arm
• Weakness when rotating the arm
• Pain in the shoulder while performing any overhead activities

How is Rotator Cuff Tear Diagnosed?

Some of the tests a physician may use to help diagnose a Rotator Cuff Tear include:

• Physical examination with complete evaluation of medical history
• X-rays: X-rays use radiation to produce images of the shoulder. This can help your physician rule-out other possible causes for shoulder discomfort, such as a fracture
• Magnetic resonance imaging (MRI): An MRI is a detailed scan in which, a magnetic field and radio waves are together used to produce images that allow a physician to view any damage to the bones and soft tissues around the shoulder joint
• General ultrasound imaging: The use of high-frequency sound waves to produce images of the shoulder

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Rotator Cuff Tear?

Complications due to a Rotator Cuff Tear may include:

• Osteoarthritis: If the shoulder joint is completely torn, arthritis may develop in the shoulder joint
• Recurrence of the injury, without adequate treatment
• RCT may restrict or limit the range of motion in the shoulder, severely affecting one’s work

How is Rotator Cuff Tear Treated?

Nonsurgical treatment:

• Any activity that aggravates the shoulder condition should be avoided. The physician may advise the individual to refrain from participating in any physical activities, till the pain or symptoms get better
• Applying ice to the shoulder/arm can help reduce pain and swelling
• Non-steroidal anti-inflammatory drugs (NSAIDs): Certain medications, such as ibuprofen and naproxen, can help reduce mild to moderate pain, within the shoulder
• Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen, can help reduce pain and swelling
• Corticosteroid injections into the epidural space (region near the spine, inside the vertebral column) help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged episodes of such injections, may injure the joints in the long-run
• Individuals are likely to need physical therapy exercises. The goals of these exercises are to strengthen the shoulder muscles, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy program and regain full strength and functionality

Surgical treatment: If nonsurgical treatments are not helpful, surgical treatment may be recommended. Common surgical procedures may include:

• Arthroscopy: Arthroscopic surgery is a moderately invasive surgical intervention that is used to repair the shoulder joint using small surgical instruments. These instruments are inserted through a small incision within the shoulder
• Open surgery: Open surgery is an invasive procedure in which, an incision is made in the shoulder, to allow the physician to repair the damaged muscles/tendons

How can Rotator Cuff Tear be Prevented?

In individuals with a history of Rotator Cuff Tear, a daily stretching exercise program may help reduce the chances of its recurrence. It is also important to incorporate exercises (into one’s activities) to help strengthen the shoulder. A few other ways would include:

• Avoid any repetitive lifting or pulling (especially overhead) of objects that are heavy
• In sports, learn the correct techniques and avoid poor (overhead) throwing techniques

What is the Prognosis of Rotator Cuff Tear? (Outcomes/Resolutions)

• Individuals with Rotator Cuff Tear, usually make a full recovery, if correct physical therapy is administered
• However, those with a more severe condition may experience recurrence of the symptoms, even after physical therapy has been completed. The duration for a complete recovery may be prolonged

Additional and Relevant Useful Information for Rotator Cuff Tear:

The ball and socket joint at the shoulder, allows the arms to move in several directions, making it the most flexible joint of the human body.