Shoulder anatomy
The shoulder is a shallow ball and socket joint that connects the arm to the body. It is called the Glenohumeral joint. The joint is made of the head of the upper arm bone (humerus) which is the ball that fits in the socket of the shoulder blade (scapula). This joint allows us to move and rotate the arm, reach behind and overhead, and perform overhead weight bearing activities.
The socket is shallow and vulnerable to dislocation, where the arm slips out of the socket. Strong connective tissues, called the rotator cuff, help to keep the shoulder stable and the arm bone in its socket.
What it the rotator cuff?
The rotator cuff is a group of four muscles and their tendons that cover and surround the shoulder joint and hold the upper arm bone (humerus) securely in its socket. It attaches the humerus to the shoulder blade and allows for lifting and rotating the arm.
What are rotator cuff tears?
Tears of the rotator cuff are tears to the tendons that attach the muscles to the bone. Rotator cuff tears are common shoulder injuries.
- A partial tear is partial detachment of the tendon from the upper arm bone.
- An acute tear can result from a fall or an accident and may be combined with other shoulder injuries such as a shoulder dislocation.
- A full thickness tear is the same as a complete tear. The tendon is torn away from the bone. It can occur from a fall or a traumatic accident, like an auto accident and often involves damage to other shoulder structures like the collarbone.
- A degenerative tear results from normal wear and tear with age. It usually affects the dominant arm. The risk increases with age.
- Overuse tears are caused by repetitive stress on the shoulder often due to sports like baseball, tennis, rowing and weight lifting. Jobs that involve heavy lifting can also cause a tear.
- Genetics play a role in rotator cuff tears. People with family members who have rotator cuff tears have an increased risk of these tears.
What are the symptoms?
- Pain or a dull ache deep in shoulder that progresses to severe pain with use
- The pain may be so severe as to interfere with sleep
- Pain and weakness experienced with the rotating, raising or lowering of the arm
- A crunching sensation when the shoulder is moved in certain positions
When should I see an orthopedic surgeon?
It’s time to see Dr. Joe Cooper, a board-eligible orthopedic surgeon with fellowship training at the Steadman Clinic when you have shoulder pain that is:
- immediate, intense pain after a shoulder injury
- chronic, long-lasting shoulder pain which is a sign of the need for surgical repair and/or
- pain and weakness that interferes with your daily life activities
It is important to seek treatment early because continued use risks further damage to the cuff and can enlarge a tear.
Your consultation
During your consultation with Dr. Cooper, he will want to know your symptoms and what caused the pain and other symptoms. He will review your medical history and conduct a physical exam to test your range of motion and arm strength; and look for all possible causes of your symptoms. He will order x-rays to show bone spurs and fractures, and an MRI to view soft tissue damage, including rotator cuff tears, their size and location, and identify whether the tear is old or new, and evaluate the quality of your cuff muscles. With all of this information he will diagnose the cause of your pain and dysfunction and make recommendations about treatment.
How are rotator cuff tears treated?
Treatment options depend upon the severity of the tear. The goal is to prevent enlarging the tear, to stabilize the shoulder, and manage your pain so you can perform normal daily activities.
Frequently, conservative measures may be recommended initially for partial tears. This will include rest, wearing a sling, over the counter anti-inflammatory medications and activity modification; and physical therapy. Steroid injections can help to reduce inflammation and reduce pain.
Contact Dr. Cooper to schedule a consultation. You will receive the right diagnosis and treatment options that will help you get back in the game.
