Patients with a rotator cuff tear usually have a dull ache in their upper lateral arm and shoulder. Over-the-head shoulder activity is difficult, so sports like tennis, baseball or swimming cause discomfort. Pain extends down to the elbow, but usually not any further. Neck pain on the same side may develop over time, as well as low dull headaches. There is progressive weakness of shoulder motion. Patients may hear a cracking in the shoulder or have difficulty getting dressed or lying on the injured shoulder.
Torn Rotator Cuff
The physician will ask for the patient's history and symptoms and perform a physical examination. X-rays can reveal evidence of arthritis, shoulder spurs, fractures or abnormal displacements of the shoulder, but they do not show the rotator cuff. Therefore, an MRI may be used since it can examine soft tissue, including the rotator cuff. The MRI images can show how the tendons are torn, and the size and length of the tear.
Physical therapy is important to all shoulder injuries. Functional exercises are used to retrain the rotator cuff muscles to do their job. The rotator cuff muscles are inherently weak, so most of the exercises involve using light weights and rubber bands. Anti-Inflammatory medications and massage may be used to relieve discomfort.
If these therapies are not effective, a conservative use of corticosteroid (cortisone) may be used in the bursa region above the tendon. This treatment will not only relieve discomfort, it may break the cycle of bursal irritation and swelling, while allowing the patient to manage strengthening exercises. The current recommendation calls for a maximum of three cortisone injections per shoulder.
Patients who have advanced rotator cuff disease or complete tears may require surgical treatment. Arthroscopic treatment, which is offered at the Emory Sports Medicine, is an innovative, minimally invasive technique used to repair rotator cuff tears.
Rehabilitation and Recovery
Surgery for rotator cuff repair requires significant recovery time. The patient will most likely wear a sling for up to four weeks. It will take approximately 12 weeks for the tendon to heal, but patients may begin light activities, such as writing, during that time. A return to full activities is usually achieved after six months.