Rotator Cuff Tear
Rotator cuff disease is the most common cause of shoulder dysfunction in the aging population. The prevalence of rotator cuff dysfunction increases with age.
The rotator cuff is a group of four muscles and their associated tendons in the shoulder that work together to stabilize the shoulder and allow you to lift and rotate the arm. These muscles and tendons attach the shoulder blade (scapula) to the upper arm bone (humerus) and help secure the ball of the arm bone firmly within the shallow socket of the shoulder.
Due to its frequent use, the rotator cuff is susceptible to injuries such as tears, strains, and tendinitis, particularly in individuals who engage in repetitive overhead activities. Rotator cuff tears cause pain that can be severe and make it difficult to perform basic, daily activities like showering, and shopping; and playing with your grandchildren.
A rotator cuff tear is an injury where one or more of the tendons in the rotator cuff muscles of the shoulder become torn or damaged. The two main types of tears:
- Partial tears – A partial tear is when one of the cuff tendons is damaged but not completely severed. The tendon may fray or sustain a small tear, leading to pain and some loss of shoulder function.
- Full-thickness tears – In this type, the tendon is completely severed from its attachment on the upper arm bone. It may due to an acute injury or degenerative changes.
- Massive irreparable rotator cuff tears – this refers to large, severe tears in the rotator cuff tendons that cannot be repaired directly. These tears typically involve multiple tendons and are often associated with significant tendon retraction, poor tissue quality, or muscle atrophy, making traditional surgical repair difficult or impossible.
- Acute Injury: A tear can happen suddenly due to a fall, lifting a heavy object, or a traumatic shoulder dislocation. This is often associated with intense, immediate pain and difficulty moving the shoulder.
- Degenerative Changes: More commonly, rotator cuff tears result from gradual wear and tear over time. Repetitive shoulder movements, especially overhead activities like those in sports (tennis, baseball, rowing and weight lifting) or certain occupations (painting, construction), can lead to tendon fraying and eventual tearing. Aging also contributes to tendon degeneration.
- Immediate intense pain and loss of function after an injury
- A deep, dull ache that gets progressively worse with use
- Pain that lasts more than a few weeks after injury
- Chronic shoulder and arm pain
- Persistent pain, especially when lifting or lowering the arm
- Weakness in the shoulder, making it difficult to lift or rotate the arm
- A cracking or popping sensation when moving the shoulder
- Difficulty sleeping on the affected side due to shoulder pain
Dr. Cinque will inquire about your symptoms and any history of injury to the shoulder. He will review your medical history assessing your history of shoulder pain and perform a physical examination testing range of motion and strength. Dr. Cinque will order imaging studies to reveal bone spurs and arthritis to rule out these causes of your shoulder pain. An MRI will show damaged soft tissues, the tear, its size and location, and muscle quality. Ultrasound is a reliable and accurate way to diagnose rotator cuff tears.
Treatment options for rotator cuff tears vary depending on the severity of the tear, the patient’s age, activity level, and overall health.
Contact Dr. Mark Cinque at Scripps to schedule a consultation to learn your shoulder pain.
At a Glance
Mark Cinque, MD
- Board-certified, fellowship-trained orthopedic surgeon
- Orthopedic Residency: Stanford University, Fellowship: The Steadman Clinic
- Authored over 100 peer-reviewed publications
- Learn more
