Rotator Cuff Tears
A rotator cuff tear is the most common shoulder condition. A tear is present in more than 50% of people over the age of 60. A tear can substantially impair the ability perform everyday activities and quality of life.
The shoulder joint is a ball and socket joint where the head of the upper arm bone (the humerus) moves in the shallow glenoid cavity on the scapula (the shoulder blade). The large head of the upper arm bone and the shallow socket are what provide a highly mobile joint, but it also makes the joint inherently unstable. Stabilizers include the rotator cuff, the labrum, capsular ligaments and the surrounding tendons and muscles.
The rotator cuff is a group of four muscles and their tendons that cover the upper arm bone. It is the stabilizing force that allows us to raise our arms overhead. During arm movement the rotator cuff muscles prevent the dislocation of the head of the upper arm bone to allow a full range of motion, while maintaining stability.
Rotator cuff tears are tears in the tendons. A tear weakens the shoulder causing even normal activities to become painful and challenging to do.
Tears may be partial or full. A partial tear results from damage to soft tissues but does not sever the tendon. With a full thickness tear, the tendon is completely detached from the bone. Tears often begin as partial tears and progress to full thickness tears with continued use.
Cuff tears are common in middle-aged and older individuals. Repetitive use activities cause microtears and can lead to partial and full tears in younger athletes.
- Acute traumatic tears often result from a fall or direct injury to the shoulder from a broken collarbone or a dislocated shoulder.
- Repetitive stress tears result from overuse or repetitive use.
- Degenerative tears result from slow degeneration of the joint, due to repetitive stress and overuse, or wear and tear degeneration that causes weakness and pain.
- Age.
- Degenerative changes.
- Smoking.
- Rotator cuff tears are more common in men.
- Sports that involve repetitive overhead motions like tennis, golf, basketball, baseball.
- Occupational hazards from mechanical overload. Construction, carpentry, house painting. This accelerates degeneration of the tendons and can be the last straw in a traumatic tear as in heavy lifting.
- Family history.
- Obesity and metabolic syndrome.
- Symptomatic tears usually affect the dominant arm.
- Shoulder pain at rest and at night, and weakness with arm rotation or with lifting.
- A dull ache or pain that worsens with use.
- Decreased shoulder function, strength, and range of motion that make it challenging to perform the daily activities of life like brushing your hair, showering, and shopping; and playing with your (grand)children.
- In up to 66% of all rotator cuff tears there are no symptoms.
- Asymptomatic tears are usually found in the non-dominant arm.
During your orthopedic evaluation, with your Hyper Regen Sports Medicine doctor, they will inquire about your symptoms and when and why the symptoms began. They will review your medical history and perform a thorough physical exam testing range of motion and strength. Imaging studies including x-rays and an MRI will reveal damage to the soft tissues and bones.
Schedule a shoulder consultation
Treatment recommendations will depend upon the tear type and size, location, and muscle quality; and whether other bone spurs or arthritis or another condition is also present.
At a Glance
Dr. Jas Chahal
- Head of Orthopaedic Surgery, Women’s College Hospital
- Team Physician Toronto FC and University of Toronto Varsity Blues
- Associate Professor, University of Toronto Orthopaedic Sports Medicine Program
- Has more than 100 peer-reviewed publications
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