What to Expect From a Torn Rotator Cuff

The rotator cuff is the group of muscles and tendons that holds the humerus bone in place in the shoulder joint and enables the arm to rotate. Since the shoulder joint is fairly weak, torn rotator cuffs are common. They are painful and require careful treatment for proper recovery.

Causes

• Torn rotator cuffs sometimes result from a traumatic injury. People most at risk for tearing their rotator cuffs are people active in sports such as baseball, tennis, weight lifting and rowing.
  The most common cause of a torn rotator cuff, however, is overuse of the shoulder joint over many years. Because of this, most patients with a torn rotator cuff are over 40.

Symptoms

• Most people with torn rotator cuffs experience pain when lifting or lowering the arm, weakness in the arm and even muscle thinning in the shoulder.
  If the rotator cuff was torn as a result of injury, there may be sudden pain, a feeling of snapping in the shoulder or immediate shoulder weakness. After the initial injury, there will be ongoing pain in the shoulder.
  If the rotator cuff was torn as a result of overuse over time, the symptoms may appear gradually and may be mild at first, but increase in intensity as time goes on.

Diagnosis

• If you think you may have torn your rotator cuff, you should see a doctor immediately. The doctor will first perform a physical exam to see where the shoulder is tender, what your range of motion is, and to check the shoulder's strength or see if there is instability. If the doctor suspects a torn rotator cuff, she will order X-rays, MRIs or an ultrasound exam to determine whether it is torn and how severe the tear is.

Treatment

• Many torn rotator cuffs can be treated without surgery. Treatment options include putting the arm in a sling, anti-inflammatory medications, steroid injections, physical therapy and plenty of rest.
  Some torn rotator cuffs do require surgery. The doctor may recommend surgery if other treatments aren't working, if the tear is extremely painful or if the tear is in the dominant arm of a very active person, such as an athlete. Many surgeries can be arthroscopic, meaning they're minimally invasive, and most surgeries are outpatient procedures.

Recovery

• The road to recovery after surgery isn't an easy one. After surgery, the arm is immobilized in a sling, usually from four to six weeks. During this period of rest, the patient is at risk of losing some mobility in the shoulder. The patient next moves on to physical therapy. Many patients recover completely, though the process may take several months.