What is the rotator cuff?
The rotator cuff starts with the upper arm bone forming a ball-and-socket joint with the shoulder bone. A series of ligaments then wrap tightly around the joint. Four muscles, commonly called the SITS muscles, also connect to the joint with strong tendons. These muscles and tendons help the arm rotate outward. Altogether, these parts make up the rotator cuff.
All torn up
Because of the joint’s complexity, there is a great chance of tears due to injury, overuse, and age. Athletes, construction workers, painters, and persons operating heavy machinery are also at risk. Most people suffer partial tears or acute tears after a fall or accident. With a full-thickness tear, the tendon or ligament is torn in two pieces or dislodged from the bone. Older persons will get degenerative tears, where the tendons wear away due to age and repetitive stress. Tears will often present these 3 symptoms. Once confirmed, seek medical help immediately.
1. A snap, crackle, and pop
Hearing a crack or popping sound after moving the shoulder? The cracking sound, called crepitus, happens at the point where the joint meets. With a damaged ligament, the bones can rub on each other, causing the cracking sound. There may be some pain with the popping sound as well.
2. Not a good night’s sleep
Sleeping with a rotator cuff tear is particularly painful. Persons with a tear are unable to sleep on the affected shoulder. Look for signs of pain during the night or waking in the morning. The pain sometimes originates on the outer shoulder.
3. An impaired movement
With a rotator cuff, the shoulder and arm are unable to move in certain positions without pain. For instance, moving the arm from rest to overhead is painful. Reaching behind the back with the affected shoulder is also painful. Anyone unable to use the full range of motion in the shoulder without pain should seek medical advice.
Is it time for surgery?
Only a medical professional can confirm if there is indeed a rotator cuff tear. Based on the type of tear, there are non-surgical treatments available. These include physical therapy, rest, and medication. If these fail, steroid injections are the next step. If these treatments fail, or if there is a complete tear, surgery is the next best step. For partial tears, a surgeon will use a technique called debridement to smooth out the ligament. Complete tears require the surgeon to stitch the tendon back to the bone. From there, physical therapy helps with full recovery.
Don’t ignore the signs
Rotator cuff tears can restrict the arm and shoulder from doing simple tasks. By identifying the signs, persons with potential rotator cuff tears can take action. Speak with a healthcare provider about non-surgical options. If these fail, consider rotator cuff surgery.