Rotator Cuff Tears

A rotator cuff tear refers to damage to any of the four tendons of the rotator cuff that stabilize the shoulder joint. Damage to the rotator cuff often is described as “tearing” or separation of the muscle-tendons from their attachment sites in the shoulder joint. This often is accompanied by decreased mobility and severe pain. The most common rotator cuff tendon to tear is the supraspinatus tendon.

A rotator cuff tear occurs when any of the four muscle-tendon groups become damaged, leading to injury of the tendon, weakness of the tendon, and surrounding inflammation. Rotator cuff tears can result from acute injuries, such as falls or lifting heavy objects, or from chronic overuse and degeneration.

Acute injury:

injuries that are acute in nature can occur as a consequence of an injury during a sport, fall, or traumatic incident (such as a motor vehicle accident). Following these injuries, you will notice an immediate onset of pain and loss of function.

Chronic overuse:

this can occur due to long-term, repetitive motions that damage the rotator cuff tendons. Examples of this include certain sports activities, such as baseball pitching, tennis and swimming, or work-related activities such as lifting heavy objects.

Degeneration:

Degeneration and tears of the rotator cuff tendons can occur as we age. This is a natural consequence of the process of normal wear and tear.

The risk of rotator cuff injuries increases as we age, and most commonly occur in people older than 40 years of age. In addition, athletes who compete in certain sports with repetitive overhead arm motions, such as baseball pitchers, tennis players, and swimmers, are more likely to develop a rotator cuff injury. Finally, a lack of shoulder muscle strength can contribute to the risk of a rotator cuff tear.

• Shoulder pain and tenderness over the lateral (outside) part of the arm, which may radiate to the elbow and worsen at night.
• Tenderness to touch on the lateral aspect of the shoulder.
• Weakness
• Swelling
• Popping sensation with arm movement.
• Difficulty sleeping.
• Difficulty performing certain activities, such as lying on the injured shoulder, carrying an object, or simply lifting the affected arm.

The combination of a detailed history, comprehensive physical examination, x-rays, and an MRI (magnetic resonance imaging) is the key to a successful diagnosis of a rotator cuff tear.

Dr. Jorge Chahla and his team will perform a thorough physical exam to identify any physical deformities, abnormal weakness, or muscle wasting. Dr. Chahla will also assess passive and active range of motion, as well as the strength, of the affected shoulder. Additionally, Dr. Chahla will use specialty tests as part of the physical exam, including but not limited to the Jobe test (empty can test), Hawkins-Kennedy test, and Lift-Off specialty tests, to properly evaluate and diagnose specifically a rotator cuff tendon injury.

X-rays will be obtained to rule out significant osteoarthritis, fracture, or bony abnormality of the shoulder, all of which could cause symptoms similar to that of a rotator cuff injury.

An MRI is an important diagnostic imaging test to evaluate the full extent of the injury and quality of the rotator cuff tendon. The MRI also allows Dr. Chahla to fully assess surrounding shoulder structures, including the superior labrum, biceps tendon, and cartilage of the glenohumeral and AC joints.