A rotator cuff tear refers to a tear of one of the tendons of the rotator cuff. The rotator cuff tendons of the shoulder are a set of tendons responsible for the movement of the shoulder in different directions. A rotator cuff tear is a cause of shoulder pain and is typically associated with weakness of certain shoulder movements. Rotator cuff tears are a common cause of shoulder pain and become more common with increasing age. Rotator cuff tears in younger people are most likely the result of a specific injury, whereas rotator cuff tears in older people are typically the result of longstanding tendon degeneration.
The rotator cuff muscles are a collection of four muscles around the shoulder; supraspinatus, infraspinatus, teres minor and subscapularis. These muscles function to move the shoulder in different directions and help to stabilise the shoulder joint. The supraspinatus tendon is the most common site of a rotator cuff tear. The muscles of the rotator cuff have tendons that surround the shoulder joint. A rotator cuff tear refers to a tear in one or more of these tendons. There are two main types of rotator cuff tear, an acute traumatic rotator cuff tear: these are tendon tears that occur following a specific injury to the shoulder. Secondly a chronic degenerative rotator cuff tear: these are tendon tears that do not have a specific associated injury. A chronic degenerative rotator cuff tear has a number of factors that can contribute to its development, however, in most cases, they occur as a result of the normal wear and tear that accompanies ageing. In fact, rotator cuff tears are often found in people without any shoulder pain. It is poorly understood why some rotator cuff tears can go unnoticed whilst others can cause significant symptoms. Symptomatic rotator cuff tears that are left untreated can result in wear and tear of the shoulder joint itself, otherwise known as rotator cuff tear arthritis.
If you develop severe shoulder pain and weakness following an injury you should seek medical attention sooner. If your shoulder pain has come on very quickly or is associated with you feeling unwell, especially with a fever, you should seek urgent medical attention.
Your doctor will ask you about your symptoms and examine you. On occasions you may require further imaging to assess the shoulder joint, this could be an X-Ray and/or an MRI scan. If a diagnosis of rotator cuff tear is made you may be given advice regarding exercises to help relieve your symptoms and improve the function of your shoulder. You may be referred to a physiotherapist in the first instance, depending upon the local services available. If your symptoms fail to improve despite physiotherapy input or are very severe, you may be referred to an orthopaedic surgeon. Additional hospital treatments that can be offered for rotator cuff tears include injections, surgery to repair the rotator cuff or joint replacement surgery if the rotator cuff tear is associated with shoulder arthritis.