The rotator cuff is a complex of four muscles and the tendons that attach them to the three bones that make up the shoulder joint. A tear in any one of the tendons is extremely common and can cause pain, weakness and limited range of motion. Tears in rotator cuff tendons develop in two ways. Young people and athletes are most likely to incur an acute tear from a fall on an outstretched arm. Older people are more likely to have chronic tears that arise slowly from repetitive overhead work. Tears can be either full thickness or partial thickness and are more often found in people older than 60 years of age. Conservative treatment of a rotator cuff tear involves rest and activity modification, wearing a sling or taking anti-inflammatory medications to relieve pain in the involved shoulder, followed by a strengthening program.
Persistent pain and limited movement are often treated by a steroid injection into the rotator cuff; more than one injection may be needed. However, if pain or weakness lasts longer than six weeks – especially if you are younger than 60, are active or use the arm for overhead work or sports – surgery may be needed to repair the tear. Ultimately, recovery from rotator cuff surgery often requires extended physical therapy and rehabilitation. Because patients often “baby” the arm to deal with pain and weakness, atrophy of the muscles around the arm and a loss of motion in the shoulder can result. Scarring around the shoulder (adhesive capsulitis) can lead to a marked restriction of the shoulder’s range of motion—a condition called frozen shoulder. In consultation with your physician or surgeon, we can design a program of physical therapy that will strengthen the muscles that surround the shoulder and improve function in the affected arm. With physical therapy to eliminate pain and weakness, you should be able to resume your sports and daily activity.