Expert Rotator Cuff Tear Treatment

Are you having trouble with shoulder pain or finding it hard to move your arm the way you usually do? You may want to seek medical attention to see if you have a rotator cuff tear.

This common condition, leading to shoulder pain and disability, affects nearly 2 million individuals in the United States every year.

At RWJBarnabas Health, we know that each rotator cuff injury is different. We pay close attention to your situation and how much it affects your life. We're here to help you figure out the best way to heal, regain your strength and say goodbye to that annoying shoulder pain.

What Is a Rotator Cuff Tear?

Animation of rotator cuff tear

A rotator cuff tear is a shoulder injury. It happens when the rotator cuff, a group of four muscles and tendons in your shoulder, is injured. These muscles and tendons are important because they help you lift and move your arm away from your body. They also keep your upper arm bone in place in your shoulder.

Think of your shoulder like a golf ball on a golf tee. That's how the ball-and-socket joint in your shoulder works. The rotator cuff can get torn if the tendons are pulled away from the arm bone. This can happen because of repetitive motions, like when painting or carpentry, or from another injury.

When you have a rotator cuff tear, you might feel pain in your shoulder or into the arm, find it hard to use your arm or feel weak. It's a common injury, especially as people get older or if they injure their shoulder suddenly.

Types of Rotator Cuff Tears We Treat

Types of torn rotator cuff injuries we treat include:

  • Partial tears. These are when the tendon is damaged but still somewhat attached to the arm bone.
  • Full-thickness tears. These are when the tendon is torn straight through and completely separated from the bone.
  • Acute tears. These severe tears result from sudden injuries and may require immediate attention.
  • Chronic tears. These develop over time from overuse or the wear and tear of aging.

Rotator Cuff Tear Causes

Rotator cuff tears can have many causes, and it is important to understand what leads to these injuries. In some cases, a sudden injury such as a fall or car accident can lead to a tear in your rotator cuff.

But more commonly, rotator cuff tears develop gradually over time due to wear and tear on the tendon. A degenerative tear happens most often in individuals over 40. Common causes of degenerative tears include:

  • Bone spurs. Bony growths can form on the top of the shoulder bone. Over time, these bone spurs can rub against the tendon, creating friction, impingement and, eventually, causing a partial or complete tear.
  • Decreased blood flow. As we age, blood flow to the rotator cuff tends to decrease. Adequate blood supply is crucial for the repair of muscles and tendons. When tendons lack nourishment from blood, they become more susceptible to tearing.
  • Overuse. Repetitive shoulder movements, whether in sports or occupational activities, can put excessive stress on the muscles and tendons, ultimately leading to a tear.

Risk Factors

Certain factors may increase your risk of experiencing a rotator cuff tear. These can include:

  • A family history of shoulder problems
  • Poor posture
  • Smoking
  • Being over 40 years old
  • Having an occupation or playing a sport that requires repetitive motions (carpenters, mechanics, and painters, for example, or those who play baseball, softball, tennis or row boats)

Rotator Cuff Tear Symptoms

The sensation of a rotator cuff tear might feel like a deep, dull ache in your shoulder. For some, it can be as intense as being stabbed with a knife. Sudden tears resulting from accidents or trauma can cause immediate, severe shoulder pain and arm weakness.

In degenerative tears, one may initially experience mild pain, which can be managed with over-the-counter pain relievers, such as ibuprofen and acetaminophen. However, as time goes on, the pain can worsen, and pain relievers and medications may become less effective.

Common symptoms of rotator cuff tears include:

  • Difficulty moving, pain and weakness. You may experience pain, weakness, or difficulty when raising, lowering, or rotating your arm.
  • Popping, clicking or crackling. Some people notice unusual sounds or sensations like popping, clicking, or crackling when moving their arms in certain positions.
  • Nighttime worsening. Shoulder pain can worsen at night or when you rest your arm.
  • Shoulder weakness. It may be challenging to lift objects due to shoulder weakness.

It is important to note that not everyone with a rotator cuff tear experiences pain, but most will notice some level of arm and shoulder weakness.

Rotator Cuff Tear Diagnosis

Your healthcare provider begins with a thorough evaluation of your symptoms and medical history. They'll ask about your shoulder pain and mobility, getting a clear picture of your condition.

During a physical exam, our specialists examine your shoulder closely. They'll press on different areas of the affected shoulder, guide your arm through various movements, and assess the strength of your shoulder and arm muscles. This helps them understand the issue's extent and how it affects them.

To get a detailed view of what's happening inside your shoulder, we use advanced imaging techniques:

  • X-ray. While a rotator cuff tear may not show up on X-rays, it can reveal other factors like bone spurs or arthritis that might be contributing to your pain.
  • Ultrasound. This noninvasive test uses sound waves to create images of your shoulder's soft tissues, including muscles and tendons. It allows us to see how your shoulder behaves during movement and compare it to your healthy shoulder.
  • Magnetic resonance imaging (MRI). MRI provides highly detailed images of all the structures in your shoulder using magnetic waves. It helps us see the complete picture of what's going on.

Our team of musculoskeletal radiologists and orthopedic surgeons carefully reviews these images to pinpoint the nature and severity of your condition. They can differentiate between tendinitis and partial or full-thickness tears, which is crucial for planning the most effective treatment.

This combination of clinical assessment and advanced imaging ensures an accurate diagnosis, helping us tailor the best treatment plan for your unique rotator cuff tear.

Rotator Cuff Tear Treatment in New Jersey

When we treat rotator cuff tears, we tailor our approach to your unique needs and the severity of your condition. We offer both nonsurgical and surgical treatment options for rotator cuff tears to ensure the best possible outcome.

Nonsurgical Treatment Options

Many patients with rotator cuff tears can experience significant improvement and pain reduction without surgery. These nonsurgical treatments focus on strengthening the shoulder muscles, which can compensate for the tear. Our nonsurgical approaches include:

  • Arm sling and rest. This allows your shoulder the time it needs to heal, which may require modifying activities and temporarily avoiding specific work or sports.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications help minimize pain and swelling.
  • Physical therapy. Specialized exercises to enhance strength and flexibility.
  • Injections. Doctors administer these to relieve pain and swelling. These include steroids, platelet-rich plasma (PRP) and stem cell injections.

Orthopedic Surgery

Your health care provider may recommend surgery if you have a complete tear, if nonsurgical treatments don't lead to sufficient improvement, or if your occupation or athletic interests exert a significant impact on the shoulder.

Most rotator cuff surgeries are minimally invasive and conducted through small incisions (arthroscopic). Doctors may perform a simple debridement procedure for partial tears to trim fraying tendon pieces and prevent further tearing and shave down prominent impinging spurs. Tears may be repaired with techniques using specialized sutures to bring the tissues back down to bone.

However, in complex cases, open surgery may be necessary. While the surgery itself is an outpatient procedure, the recovery period is substantial, often lasting many months.

Health care professionals may explore alternative options for tears that cannot be repaired due to their size or age, including:

  • Tendon transfer
  • Scar tissue debridement without repair
  • Tendon augmentation with allograph or synthetic materials
  • Reverse shoulder replacement for end-stage disease with advanced arthritis

Recovery from Rotator Cuff Tears

Central to the recovery journey are personalized orthopedic rehabilitation programs designed to help patients regain strength, restore range of motion and enhance overall function. Physical therapy is pivotal in nonsurgical and postoperative recovery, focusing on exercises that promote flexibility and shoulder strength.

Recovering from rotator cuff surgery is gradual and can span several months. Following surgery, we provide patients with expert guidance on managing pain and resting effectively under their doctor's care. Our specialists, including physical therapists, orthopedic experts and pain management professionals, collaborate to create a customized rehabilitation plan. This plan takes into account the type of surgery performed, the patient's unique needs, and personal recovery goals.

Expert Care for Rotator Cuff Tears

At RWJBarnabas Health, our highly qualified team of orthopedic surgeons and specialists, equipped with the latest technology and expertise, delivers top-tier care for rotator cuff tears. We are committed to helping patients regain strength, reduce pain, and improve shoulder function.

Don't let a rotator cuff tear hinder your lifestyle. Timely and expert care from our specialists can prevent complications and expedite your recovery. Trust RWJBarnabas Health for comprehensive and skilled care for your rotator cuff injury.


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