A Common Shoulder Injury: Rotator Cuff Tears and Strains

Rotator cuff injuries are common, especially as you get older. A rotator cuff tear or strain makes it difficult to raise and move your arm. You may have shoulder pain and arm weakness. Rest, pain relievers and physical therapy can help, but some people will need surgery.

The rotator cuff is a group of four stabilizer muscles and tendons in your shoulder. They help you lift and move your arm. Rotator cuff injuries occur when the tendon is pulled away from the arm bone.

Both a tear and strain have similar symptoms of pain, swelling and stiffness. With a tear, the arm can barely move overhead and sharp pains occur. Strains tend to happen over months or years of overuse and feel like a dull ache deep in the shoulder.

Symptoms of a rotator cuff injury:

Recurrent pain, especially with certain activities

Pain that disturbs sleep or prevents you from sleeping on your injured side

Grating, clicking, popping or cracking sounds when moving your arm

Limited range of motion of the arm and shoulder, and muscle weakness

Difficulty and pain when lifting the arm up or reaching behind your back

Shoulder pain that worsens at night or when resting your arm

Shoulder weakness and struggling to lift items

Rotator cuffs tears can be partial or complete. With an incomplete or partial tear, the tendon is still somewhat attached to the bone. With a complete tear, the tendon separates completely from the bone and there is a hole or rip in the tendon.

There are multiple causes of rotator cuff tears and strains. Most commonly, it occurs over time as the tendon wears down with age and use (degenerative tear or strain). People over 40 are most at risk.

Bone spurs, bony growths that form on the top of the shoulder bone, can also be a cause. These bone spurs rub against the tendon when you lift your arm, eventually causing a partial or complete tear.

Decreased tendon flow occurs as you get older and blood flow to the rotator cuff decreases. 

Overuse, by making repetitive shoulder movements during sports or on the job, can stress muscles and tendons, causing a tear.

In some cases, it is an acute injury from an accident.

A rotator cuff tear or strain can get worse without treatment. A complete tear can make it almost impossible to move your arm. This can result in chronic pain and make it very difficult to use the injured arm. Tears do not heal on their own without surgery, but many patients can improve function and decrease pain with nonsurgical treatment, by strengthening their shoulder muscles. About eight out of 10 people with partial tears get better with nonsurgical treatments, but it can take up to a year for the condition to improve.

Nonsurgical treatments include resting the affected side to give your shoulder time to heal. You may need to modify activities and stop certain work and sports for a period of time. A sling can be used if you find it hard to avoid using the affected arm. Nonsteroidal anti-inflammatory drugs, if tolerated, can be taken to minimize pain and swelling. Steroid injections are another option to ease pain and swelling.

Physical therapy can be sought to learn strengthening and stretching exercises. Your personal trainer can work with your physical therapist to help you with these. While a personal trainer can’t diagnose a rotator cuff injury, they can refer you for treatment if it appears to be a possible tear or strain.

Your healthcare provider may recommend surgery if you have a complete tear or nonsurgical treatments don’t help a partial tear. You may also need surgery if your job or athletic interests would be affected by the injury.

To prevent a rotator cuff tear or strain, it’s important to keep your muscles and tendons both strong and flexible. Your personal trainer or physical therapist can teach you stretching and strengthening exercises to do at home or at the gym. Common exercises are range-of-motion movements for the shoulders, and internal and external rotation. Other exercises to target different parts of the deltoid muscles can be helpful. Your trainer or therapist can also help you work around any other shoulder issues you may have to help you get and stay stronger and pain-free.

Lori Vance

Body Image Fitness, LLC


Editor’s note: Wellness Word is an informational column which is not meant to replace a healthcare professional’s diagnosis, treatment or medication.

A Common Shoulder Injury: Rotator Cuff Tears and Strains

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