What is a Rotator Cuff Tear?

A rotator cuff tear is a tear of one or more of your rotator cuff muscles that usually occur in the tendon where it connects onto the shoulder. You have four rotator cuff muscles which originate at your shoulder blade and attach to the top of your arm to the humerus bone. They work collectively to provide support and stability to your shoulder joint.

If you sustain a rotator cuff tear you are likely to experience shoulder and arm pain, restricted shoulder movement and pain at night. Sometimes rotator cuff tears can occur slowly without any pain or discomfort. This is thought to occur due to older age, compression (impingement) of the tendons and repetitive shoulder activity. After sustaining a rotator cuff tear you may have pain or difficulty raising your arm above your head, reaching out in front of your body and pain with lying on the shoulder at night. Small to medium tears respond well to physiotherapy. Large tears or ruptures may require surgery.

Why does it happen?

Rotator cuff tears can be caused by an acute fall or from chronic degeneration of the tendon. Impingement (pinching) of the rotator cuff tendons between the top of the shoulder blade (acromion) and the ball of the shoulder (humerus) is thought to be the main cause of rotator cuff tears. They can also occur in activities that involve overhead movements, repetitive arm activity, heavy lifting or some throwing sports.

What can a physiotherapist do?

In the initial stages of a rotator cuff injury the physiotherapist can help reduce the pain and maintain range of movement of the shoulder. The physiotherapist may refer you for further investigations to assess the extent of the rotator cuff tear.

Physiotherapy treatment may involve soft tissue massage, mobilization, electrotherapy, dry needling, supportive taping, and gentle range of movement exercises. The physiotherapist will further progress your exercises to improve the strength and stability of your shoulder as the condition improves.

What about activity?

Your physiotherapist will provide advice regarding the safe return to work and normal activity. Most of the time activities are able to be modified and do not have to be ceased completely.

Outcome

Rotator cuff tears generally take time to heal. The recovery time is variable and may take several months. Being diligent by completing your exercises is very important. Most small tears heal well without surgery. Those who do not respond to physiotherapy despite adequate rehabilitation and time will benefit from a surgical opinion. Rotator cuff tears that require surgery will need an extensive rehabilitation regime. Full recovery is reached at 6 months to one year after surgery.