Understanding Rotator Cuff Tears

Rotator cuff tears are a common cause of shoulder pain and discomfort, affecting millions of people worldwide, and in Australia alone, it is estimated that over 700,000 people suffer from a rotator cuff tear. The rotator cuff is a group of muscles and tendons that attach the upper arm bone to the shoulder blade and provide stability to the shoulder joint. A rotator cuff tear can be caused by injury, overuse, or aging, and can range from mild to severe. In this article, we will explore the causes, symptoms, and treatments of rotator cuff tears, as well as some tips for prevention.

What is the rotator cuff?

The rotator cuff is a group of four muscles in the shoulder:

• Supraspinatus

• Subscapularis

• Infraspinatus

• Teres minor

These muscles work around your shoulder blade and humerus, to provide stability to your shoulder joint as you move. Think of them as “the core muscles” of your shoulder. These muscles allow the larger muscles around your shoulder, which you may be more familiar with, such as the deltoid, pecs, and lats to move the arm powerfully and in a controlled manner with these deeper rotator cuff muscles assisting to control and support that movement. Because they are such important muscles, they are also prone to injury.

What Causes Rotator Cuff Tears?

Rotator cuff tears can be caused by a variety of factors, including:

• Impact of direct trauma: An injury involving a fall or a sporting injury, usually involving an impact
  

• Overuse: Continued repetitive movements, usually overhead, that can cause breakdown of the tissue or tearing over time, i.e. repetitive lifting or painting a ceiling
  

• Aging: As we age, the rotator cuff tendons can become weaker, brittle, and more susceptible to injury.
  

Symptoms of a Rotator Cuff Tear

The symptoms of a rotator cuff tear can vary depending on the severity of the injury. Some common symptoms include:

• Pain in the shoulder, especially when lifting or reaching overhead

• Weakness in the shoulder

• Stiffness in the shoulder

• A crackling sensation when moving the shoulder

Diagnosis and Treatment of Rotator Cuff Tears

If you suspect you have a rotator cuff tear, it is important to see a Physio. They will be able to perform tests to ascertain the specific tissue or rotator cuff that is damaged and provide an individualised treatment plan to assist recovery. If necessary, your Physiotherapist can also refer you directly for an x-ray or MRI if needed

The treatment for a rotator cuff tear will depend on the severity of the injury. Your physio will employ a number of options to assist the tissue in healing and recovering; these may include:

• Hands on manual therapy

• Taping to unload the injured tissue and assist in healing

• Cryotherapy i.e. Game Ready unit

• A progressive strengthening program

• Education on activity modification and a self-direct home therapy program

In more severe cases, surgery may be necessary to repair the rotator cuff and your Physio can assist with planning for this and also selecting the best suited surgeon for you.

Tips for Preventing Rotator Cuff Tears

While rotator cuff tears can be difficult to prevent, there are some steps you can take to reduce your risk:

• Strengthen the rotator cuff: Exercises that target the rotator cuff muscles can help strengthen the tendons and reduce your risk of injury.
  

• Avoid repetitive overhead movements: If you participate in sports or manual labor, try to avoid repetitive overhead movements that can put strain on the rotator cuff.
  

• Maintain good posture: Poor posture can lead to shoulder strain and increase your risk of rotator cuff injury.
  

Conclusion

Rotator cuff tears are a common cause of shoulder pain and discomfort. While they can be difficult to prevent, taking steps to strengthen the rotator cuff, avoid repetitive overhead movements, and maintain good posture can reduce your risk of injury. If you suspect you have a rotator cuff tear, it is important to see a physio for proper diagnosis and treatment.