Rotator cuff tears are a common source of shoulder pain.
According to the American Academy of Orthopedic Surgeons, rotator cuff tear injuries are on the rise with aging patients across the United States. Rotator cuff tears (RCTs) are among the most common upper extremity injuries in individuals older than 50 years of age, with nearly 20 percent of patients over the age of 50 exhibiting symptoms of RCTs and 49 percent of patients over 70 showing symptoms of RCTs. Because most RCTs are a result of normal wear and tear that coincide with aging, recognizing the symptoms and seeking treatment can help individuals prevent symptoms from getting worse.
The rotator cuff is a group of four muscles that come together as tendons to create a covering around the head of the humerus bone in the upper arm. A rotator cuff tear occurs when one or more of the rotator cuff tendons are torn and the tendon does not fully attach to the humerus. The tear can cause pain when lifting an arm out to the side or rotating the arm. There are different types of rotator cuff tears including a partial tear, which damages the soft tissue, but doesn’t sever it; and the full-thickness tear, which splits the soft tissue into two separate pieces. The full-thickness tear is essentially a hole in the tendon.
Causes for rotator cuff tears fall into two main categories, injury and degeneration. An individual can fall down or lift something large or heavy to cause a rotator cuff tear. When a rotator cuff tear is caused by an injury, it is called an acute tear. Acute tears can also be associated with other shoulder injuries, like shoulder dislocation. The majority of RCTs fall into the latter category – degenerative tears. Over time the tendons in the upper arm wear down due to use. As we age, the rotator cuff in the dominant arm will tend to exhibit the symptoms of an RCT. Those that have a degenerative tear in one shoulder are also at the greatest risk for a rotator cuff tear in the opposing shoulder.
Contributing factors of degenerative rotator cuff tears include:
– Repetitive stress – Doing the same shoulder motions repeatedly can wear the tendons down at a greater rate. This happens for people who are athletes or perform repetitive lifting activities at work or home.
– Lack of blood supply – Blood supply to the rotator cuff tendons decreases as we age. Without a favorable blood supply the body’s natural ability to repair the tendon will be impaired, which could lead to a tendon tear.
– Bone spurs – Bone overgrowth in the upper arm can cause what’s called a shoulder impingement, which can weaken the tendons over time and cause a tear.
Tears can happen suddenly or over time. The most common symptoms of RCTs include pain in the upper arm or shoulder area at rest, at night if lying on the affected shoulder, and pain or weakness when lifting or lowering the arm.
For those that have RCTs, seeking immediate medical attention is advised. If you have a rotator cuff tear and you keep using the shoulder, further damage can occur and the tear can get larger over time. Chronic upper arm and shoulder pain is a good reason to visit with your orthopedic specialist. There are many options for treating RCTs and your orthopedist can help you best decide which treatment option will work for you.
Dr. John Kagan has more than 30 years of experience as an orthopedic surgeon treating patients in Southwest Florida. He specializes in treating patients with knee, shoulder and hip pain, as well as general orthopedics and hand surgery. For more information go to www.kaganortho.com or call 239-936-6778.