Rotator Cuff Tears - Diagnosis, Treatments, and Procedures

Rotator cuff tears are common injury seen among athletes and people with active lifestyles caused by overuse or acute injuries. Below Dr. Fotios Tjoumakaris, sports medicine specialist at Rothman Orthopaedic Institute, answers our common questions asked about rotator cuff tears and treatment options.

What is the rotator cuff?

The rotator cuff are 4 muscles that surround the ball and socket joint of the shoulder.  They are important in the daily use of our arm by stabilizing the joint, helping to elevate the arm, and help you to perform repetitive, high performance tasks.

How does my rotator cuff get injured?

The most common way our rotator cuff is injured is through normal wear and tear.  Less commonly, an injury such as a fall or a distracting force to the arm can contribute to a rotator cuff injury.  We commonly refer to these injuries as “rotator cuff tears.”

Can I prevent a rotator cuff tear?

While preventing the normal wear and tear of our shoulder muscles can be difficult, there are certain things that can minimize our risk of injury.  These include:

• Avoiding high risk, repetitive overhead activity
• Minimizing lifting heavy weight overhead
• Using proper technique when lifting
• Adequately resting between periods of intense physical activity (e.g. baseball pitching)
• Control blood sugar and cholesterol levels, and avoid cigarette smoking

What are the symptoms of a rotator cuff tear?

The most common symptom of a rotator cuff tear is pain around the shoulder.  This pain is typically located in the lateral, upper arm (“policeman’s patch” pain – pain where a police officer has his patch on his uniform is the most common location).  You might have symptoms of pain with lifting the arm overhead or might notice weakness in your ability to move your arm.  In rare instances, people might not even be able to lift the arm at all if their tear is large enough.  In a study that we performed at the Rothman Orthopaedics, we found that 89% of patients also reported sleep disturbance secondary to their rotator cuff problem.  After successful treatment, this number was reduced in half.

How is a rotator cuff tear diagnosed?

The majority of patients can be diagnosed with a detailed history, physical examination, and diagnostic imaging (such as an MRI).  Evaluation by a physician trained in musculoskeletal medicine (e.g. sports medicine) is often necessary so that prompt diagnosis and treatment can be offered in the same clinical setting.

How do I treat my rotator cuff tear?

The majority of patients with rotator cuff tears can be successfully treated without surgery.  Treatment options in this instance might include activity modification, non-steroidal anti-inflammatory medications (NSAIDs), cortisone injections, and physical therapy.  In some instances, surgery might be recommended if either conservative measures fail to help improve symptoms, or if the tear is large enough to significantly compromise your function.  Thankfully, advanced surgical techniques such as arthroscopy have reduced post-operative pain, lessened scar tissue formation, and have achieved high success rates.

I’ve heard that rotator cuff surgery is very painful and difficult to go through, is that true?

Historically, rotator cuff surgery has been noted by patients to be painful and the rehabilitation arduous.  Recently, however, we have employed several methods to reduce post-operative pain and improve outcomes.  Nerve blocks performed at the time of surgery for pain relief can now give patients up to 72 hours of pain relief after surgery, with many patients reporting that they didn’t even require pain medication after the procedure.  Arthroscopic, minimally invasive techniques have also reduced pain levels and led to less scar tissue formation.  While every patient heals and responds to surgery differently, many patients report that their surgical experience was much better than they had expected.

I think I may have a rotator cuff tear, what’s my next step?

Make an appointment with one of our fellowship trained sports medicine or shoulder specialists! At Rothman Orthopaedics, we don’t employ a one size fits all approach.  Your treatment will be specifically designed for your circumstances (duration of symptoms, activity level, and your specific diagnosis).  For instance, not everyone with the same rotator cuff tear is treated the same way as they may have different presenting symptoms or issues that dictate their treatment approach.  We listen to our patients, go over their imaging in detail with them, and employ shared decision making where we come up with the best treatment plan together. 

For more information on rotator cuff tears or to make an appointment with a Rothman Orthopaedics specialist, please call 1-800-321-9999 or visit RothmanOrtho.com.

Dr. Tjoumakaris specializes in sports medicine and shoulder surgery with special expertise in shoulder, knee, and hip arthroscopy and reconstructive procedures.