Rotator Cuff Tear

The rotator cuff is a group of muscles and tendons that surround the shoulder joint. These muscles and tendons hold the arm in its joint. They also help the shoulder move and rotate. The rotator cuff can be torn from overuse or injury. Gradual wear and tear can lead to inflammation of these tendons. This can progress to gradual or sudden tears.

Symptoms of a torn rotator cuff include:

  • Shoulder pain that gets worse when you raise your arm overhead

  • Weakness of the shoulder muscles with overhead activity

  • Popping and clicking when you move your shoulder

  • Shoulder pain that wakes you up at night when sleeping on the hurt shoulder

Your healthcare provider may suspect a rotator cuff injury based on your symptoms and a physical exam. You may have an X-ray, MRI, or arthroscopy. Arthroscopy is a surgical procedure to look inside the joint through a small tube. X-rays may be taken to find out if there is another reason for your pain, such as an abnormality in the bone.

Partial rotator cuff tears can be treated by first resting, then strengthening the rotator cuff muscles. Anti-inflammatory medicines, such as ibuprofen or naproxen, are useful. Your healthcare provider can give you a limited number of steroid injections. Your provider may advise surgery for complete tears and partial tears that don't respond to medical treatment.

Home care

  • Try to avoid activities that make your pain worse. This includes overhead activities, doing the same motion over and over, and heavy lifting.

  • You may use over-the-counter pain medicines to control pain, unless another medicine was prescribed. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen may work better than acetaminophen. If you have chronic liver or kidney disease, ever had a stomach ulcer or gastrointestinal bleeding, or take a blood thinner, talk with your healthcare provider before using these medicines.

  • If you were given a sling, use it for comfort. After your pain decreases, don’t keep your arm in the sling all the time. Take your arm out several times a day and move the shoulder joint, as you are able.

  • Your healthcare provider may advise gentle pendulum exercises. Stand or sit with your arm vertical and close to your side. Relax your shoulder muscles and gently swing the arm forward and back, side to side, and in small circles for about 5 minutes. Do this once or twice a day. There should be only slight pain with this exercise.

  • You may benefit from physical therapy or a home exercise program to strengthen your shoulder muscles. This will also increase your pain-free range of motion. Applying heat before exercises can help prepare the muscles and joint for activity. Talk to your healthcare provider about what is best for your condition.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to get medical advice

Call your healthcare provider right away if the following occurs:

  • Increasing shoulder pain or pain radiating down the arm to the hand

Call 911

Call 911 if any of these occur:

  • Rapid swelling in the affected shoulder or arm

  • Numbness, tingling, or loss of strength down the arm to the hand

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