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Rotator Cuff Tear

The rotator cuff is a group of muscles and tendons that attach the upper arm bone to the shoulder blade. The rotator cuff helps to keep the arm in its socket, stabilize the shoulder, and provide the ability to lift and rotate the arm. A tear in one or more tendons can cause severe pain and weakness in the shoulder and make it difficult to perform the daily activities of life like showering, combing your hair, shaving, shopping, and playing with grandchildren.

Rotator cuff tears can occur at any age, but most tears occur in middle-aged patients due to wear and tear. Also with age the blood supply to the cuff is reduced which contributes to degenerative tears.

Overuse/ repetitive stress tears

A rotator cuff tear may be caused by repeated overhead arm motions, such as those often used in tennis, swimming, baseball, rowing, and weightlifting. Occupations that involve repetitive overhead motions like construction, painters and heavy labor can lead to rotator cuff tears.

Acute, traumatic injury tears

A from a fall on an outstretched arm, heavy lifting, a broken collarbone, a dislocated shoulder.

Degenerative tears

With age and wear and tear the rotator cuff tendons can fray from mechanical damage which will eventually lead to a tear. Bone spurs can accelerate wear and tear.  Rotator cuff tears are common affecting about 60% of the population over age 60.

Partial or full tears?

  • Tears may be partial or complete. Partial tears damage the soft tissues, but the cuff remains partially attached. Sometimes partial tears do not cause symptoms. Studies report that a partial tear that causes no symptoms typically enlarges over three years and becomes symptomatic, causing weakness and other symptoms.
  • A full thickness tear is where the tendon is torn off the bone.

The most common symptom of a rotator cuff tear is pain in the shoulder, particularly when lifting the arm overhead or when lying down on the affected side. Other symptoms may include:

  • pain that interferes with sleep
  • loss of strength
  • weakness when lifting and rotating the arm
  • reduced range of motion
  • a crackling sensation when moving the shoulder
  • a deep ache that gets progressively worse
  • chronic shoulder and arm pain. Chronic pain is an indication that surgical repair is necessary. Continued use increases the risk of additional damage to the cuff muscles and tendons.
  • Small tears may only cause pain, but large tears cause an imbalance in joint function that limits the reach and strength of the arm.

Shoulder pain is common and has a diverse range of causes including biceps tendinitis, frozen shoulder, bursitis and more. Dr. Patel must rule out these and other causes of your shoulder pain.

He will review your medical history, ask about your symptoms, your occupation and athletic and leisure activities, how long you have been in pain, and what causes your pain. He will conduct an orthopaedic evaluation testing range of motion and strength. He will order imaging studies including X-rays to evaluate the joint for osteoarthritis, fractures and bone spurs, and an MRI to evaluate the soft tissues including the rotator cuff.

Rotator cuff tears are a common cause of shoulder pain. An important warning sign in addition to chronic shoulder pain is difficulty raising the arm. It is a good idea to see Dr. Patel.

Dr. Ronak M. Patel is a double board-certified orthopaedic surgeon and sports medicine physician. He completed his bachelor’s degree, medical degree, and residency training at Northwestern University. He, then completed his fellowship training at the Cleveland Clinic. He specializes in the treatment of complex knee, shoulder and elbow injuries and degenerative conditions. Contact him to schedule a consultation to learn more about how he can help you return to the life you love and the activities that make life worth living. He serves teens and adults in Chicagoland and NW Indiana.

At a Glance

Ronak M. Patel M.D.

  • Double Board-Certified, Fellowship-Trained Orthopaedic Surgeon
  • Past Team Physician to the Cavaliers (NBA), Browns (NFL) and Guardians (MLB)
  • Published over 49 publications and 10 book chapters
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