Rotator Cuff Tear - What Caused Yours? And What Treatment Is Best?
Four muscles make up the group of muscles called the rotator cuff that help to keep the top of the arm bone in place in the socket of the shoulder joint. If we didn't have them you would find your shoulder joint dislocating every time that you tried lifting anything. All these muscles connect to the scapula or shoulder blade at one end and the upper arm or humerus at the other and surround the shoulder forming a cuff of muscle around the shoulder joint, which is how they got their name.
If one or more of these muscles gets torn you have a rotator cuff tear either through wear and tear or a knock or fall. One analogy I have heard is that of comparing the tendons of the cuff to a car tow rope. If you try pulling something that is too heavy the rope will tear or snap and if you have been using the same old tow rope for several years it can become frayed through use.
Rotator cuff tears often come about through a sudden trauma. If, for example, you were to fall and put your arm out to catch yourself the sudden load can tear one of the tendons. Lifting something heavy could have the same effect but would cause a different type of damage as the load is likely to be added more evenly and gradually. The muscles and tendons can also just wear out through repeated use either through age or because a work or leisure activity over uses the muscle. Anyone who throws a baseball repeatedly is putting strain on these muscles. Any repetitive overhead action like decorating can have teh same effect.
If you tear your rotator cuff you will experience specific symptom such as weakness in the arm, pain when doing certain movements, especially reaching up or behind you. The normal test for a tear will usually involve getting someone to gently push against the doctor's hand whilst mimicking these movements; if this causes pain then you probaly have a torn rotator cuff.
The therapy can vary depending on the age of the person and the severity of the tear. Short or small tears are easier to repair and may only need anti-inflammatory drugs and physiotherapy, whilst larger tears may involve keyhole surgery to mend the tear or free up space for the inflamed muscle to move more easily eliminating pain altogether or limiting it.
If you are younger when you have surgery the greater the success rate. As you get older the success rate of the procedure can drop to around 60%. It is sometimes worth considering what you see as a successful outcome. Obviously, if you are a keen sportsperson the ideal outcome would be a return to total fitness. On the other hand, if you lead a fairly placid lifestyle the aim may be to be able to carry out certain tasks and movements without pain or discomfort.
Rotator cuff tears come in a variety of shapes and sizes and so they can vary quite considerably in terms of prognosis and treatment. Physiotherapy will be involved in any treatment but it needs to be rotator cuff specific exercises aimed at exercising and strengthening the group of muscles without causing any further damage.
