A rotator cuff tear is a tear in one or more of the four tendons that form the deepest layers of muscles within the shoulder. Tendons are what attach these muscles to the bone, which rotate the arm. Both muscles and tendons come together to form a "cuff" around the shoulder — hence the term "rotator cuff." Rotator cuff tears can be small and involve only a portion of a single tendon or they can be large and involve multiple tendons.
The hallmarks of a rotator cuff tear are pain, weakness, and lack of active motion. Tears can happen after trauma, called traumatic tears, or they can occur gradually over months and years, and are called degenerative tears. Many people complain of a deep ache that affects the top and side of the shoulder as well as difficulty sleeping at night.
The doctor will begin by performing a physical examination on the patient’s shoulder. Evaluation methods such as X-rays do not show tears in the rotator cuff, but are helpful in identifying associated bone shapes and arthritis that can lead to chronic tears. Additionally, MRI and ultrasound evaluations may be needed to demonstrate the extent of the tear.
Athletes, individuals over forty, and construction workers have a higher risk for rotator cuff tears. The acute or chronic effects of falling, lifting objects overhead, and repetitive shoulder movements can lead to this condition. These movements can also cause tendonitis that, if left untreated, can develop into a rotator cuff tear. Poor posture, lifting objects that are too heavy or lifting weights with improper form can result in rotator cuff injuries. Avoiding these habits can significantly lower the risk of developing this condition.