What does "ruptured rotator cuff" mean?
The rotator cuff is a group of muscles whose tendons wrap around the shoulder joint and stabilise it. If one or more of the tendons tear, this is referred to as a ruptured rotator cuff, or a rotator cuff tear. The rotator cuff consists of four muscles: the supraspinatus, infraspinatus, teres minor and subscapularis. These muscles work together to coordinate the movements of the shoulder joint.
How does a rotator cuff tear happen? Causes and risk factors
Lateral view of the rotator cuff
There are various reasons why a rotator cuff tear happens. A full tear can happen quicker if the muscles and tendons that stabilise the shoulder are already damaged. Typical causes and risk factors are:
- Ageing and degenerative changes
- Chronic overloading: Repeated strain on the shoulder muscles due to particular movements or activities
- Acute injuries: Sudden, traumatic events such as falls, accidents or sports injuries
- Chronic inflammatory conditions
How do you prevent a rotator cuff tear?
Specifically strengthening the shoulder muscles and avoiding straining the shoulder on one side can have a preventive effect, so a well-rounded exercise regime and regular breaks during strenuous activities are recommended.
Symptoms and signs of a ruptured rotator cuff
The symptoms of a ruptured rotator cuff can be pain in the shoulder area on certain movements, loss of strength, and impaired mobility. In some cases, especially when caused by degeneration, the tear can also be asymptomatic. Often, those affected also report pain at night and difficulty lifting their arm.
Diagnosing a ruptured rotator cuff: How do they detect a tear in the rotator cuff?
It is important to diagnose and treat rotator cuff rupture early to minimise long-term complications and restore shoulder function. A rotator cuff rupture is usually diagnosed by clinical examinations and imaging procedures, such as magnetic resonance imaging (MRI) or ultrasound.
Ruptured rotator cuff therapy and treatment
Treatment can be conservative (physiotherapy, medication) or surgical (tendon repair surgery), depending on the severity of the tear. The individual treatment depends on various factors. The final decision should be made in close consultation with a medical professional. Conservative approaches can be very effective in the following situations
Partial tears
If the tendon is not completely torn, non-surgical treatment may be considered.
Lack of any serious symptoms
If the doctor and patient agree that the symptoms and loss of function are tolerable, conservative treatment might be sufficient.
The patient's state of health
Older patients or people with existing health issues may ultimately elect not to undergo surgery, after weighing up the benefits and risks.
The patient's preferences
The personal preferences of the person concerned as well as their willingness to cooperate with physiotherapists, can be a factor in the decision for or against conservative treatment.
Surgery might be favourable in the following circumstances:
- Size of the tear: Surgery is the treatment of choice for large tears, especially those affecting the entire thickness of the tendon.
- Shoulder mobility: If the person concerned is severely restricted and their ruptured rotator cuff rupture is causing a significant loss of strength, surgery may be necessary.
- The patient's age: Physically active patients, especially younger ones, generally undergo surgery to restore full shoulder function.
When weighing up the pros and cons of surgery, the doctors consider the person's overall health and restrictions, and identify possible contraindications.
medi products for ruptured rotator cuffs
Depending on the severity of the injury, orthoses and physiotherapy can be used to support the patient. They are chosen on a personalised basis in consultation with a medical professional.
