Rotator cuff tear

What is rotator cuff tear?

There are four tendons in the shoulder that make up the ‘rotator cuff’. As we age these tendons undergo gradual wear and tear. The tendons develop small tears and become inflamed. If the degeneration continues to progress the tendon may completely tear, resulting in a ‘rotator cuff tear’. Sometimes tendons tear after an injury. Of the four tendons, the supraspinatus tendon is the most commonly involved.

Symptoms of rotator cuff tear

Common symptoms of rotator cuff tears include:

• difficulty sleeping due to pain, particularly at night
• pain in the arm, particularly when using the arm away from the body or overhead
• weakness in the shoulder with limited movement

How is rotator cuff tear treated?

After assessment by an orthopaedic surgeon or physiotherapist with a special interest in musculoskeletal problems the condition is diagnosed with an ultrasound scan.

Rotator cuff tears will often progress well with physiotherapy to strengthen all the muscles around the shoulder and stretch out any tightness in the joint. In extensive tears, where weakness is the main problem, it is often possible to strengthen the other muscles around the joint to regain a good range of movement and therefore good function in the arm although it may remain weak especially overhead.

Severe or ongoing pain is usually treated with a steroid injection followed by specialist physiotherapy approximately two weeks after injection. The injection procedure is performed by a consultant radiologist using ultrasound and takes only a few seconds to do. The steroid usually takes effect by one week. After the injection many patients find the greatest benefit is being able to sleep without being woken by pain.

If the shoulder does not improve with these conservative treatments, surgery to repair the tendon could be considered and this would be discussed in an appointment with the orthopaedic surgeon.