If you fell backwards and landed on your shoulder and haven't been able to lift your arm since, you may have a rotator cuff tear. The pain can be excruciating, of course, but the most annoying thing about a rotator cuff tear is that you are physically unable to lift your arm. Every part of everyday life becomes difficult, if not impossible . . . including sleeping.
While many injuries do heal over time and can be ignored, a rotator cuff tear cannot and should not be ignored. Your range of motion may slightly improve on it's own, but your shoulder may cause you problems for the rest of your life if you don't seek medical treatment. Here's what you need to know.
The rotator cuff connects your upper arm bone to your shoulder blade. The rotator cuff is a formation of the tendons from four muscles. Normally, the tendons are pulled on by the muscles to move the bones. The damage to the tendons in your rotator cuff is preventing you from being able to lift your arm. Smaller tears will cause pain and decreased movement. However, larger tears will cause the tendons to be unable to do their job. It is also possible to completely tear a rotator cuff, which would result in the complete inability to lift your arm and severe pain.
Another role of the rotator cuff is to keep the upper arm bone in the socket of the shoulder blade. The top of the rotator cup is called the acromion, and within this roof-like structure is a lubricated sac called the bursa. The role of the bursa is to reduce the amount of friction between the upper arm bone and the shoulder blade. Without this protection, bone spurs may grow. A large tear in the rotator cuff may prevent the bursa from doing its job of reducing the friction between the bones. Bone spurs may cause you to hear grinding sounds in your shoulder and may cause inflammation in the bursa, which is called bursitis.
The Treatment Options
The type of tear you are experiencing will need treatment. The longer you wait to get treatment, the more involved your treatment may be. While tears typically do not worsen over time, bursitis and bone spurs can. There are nonsurgical and surgical treatment options available, which will be discussed with you following imaging and range-of-motion testing by an orthopaedic surgeon at a medical center like Tedder Sports Medicine & Orthopaedic Center.
Ideally, nonsurgical treatment should be taken first, with surgical treatment being done if nonsurgical treatment fails. Nonsurgical treatment consists of prescription medication to control the inflammation and a cortisone injection to control pain. Heat and ice treatments and physical therapy to improve the range of motion of the affected muscles are also recommended treatment options.
It's important to note that a complete rotator cuff tear will not heal without surgical intervention. This type of surgery is typically done with an arthroscope, which allows the surgeon to look at the joint via a small camera that is inserted into a small incision. The surgeon may need to place several anchors in the tendons to reatttach them to the bone. Bone spurs, if any have formed, can be removed in the same surgery.
After surgery, you will need to work with a physical therapist to regain muscle strength and improve your range of motion. The physical therapist will teach you various exercises that you will be able to do in the comfort of your home. The exercises will progress and allow for greater range of motion and improved strength in correlation to the healing progress of the surgical site.