Injury and overuse are the two most common causes of shoulder tendon tears. Signs and symptoms of a shoulder tendon tear may include:
- Dull, deep pain in the shoulder
- Pain at night, particularly when sleeping on the affected side
- Tenderness or swelling in the shoulder
- Inability to bear weight on the affected side
- Bulge or deformation around the shoulder
- Hearing or feeling a snap or popping when moving the shoulder
- Shoulder weakness, which is frequently caused by pain on exertion
- Shoulder stiffness with some inability to move the affected area
- Inability to keep the arm elevated
Shoulder tendon tears can be either partial or complete:
- Partial tear: Occurs when the tendon is not completely severed
- Complete tear: Causes the tendon to split into two sections
What is the rotator cuff?
Your shoulder is your body's most flexible joint. The rotator cuff is a collection of four muscles and tendons that aid in the movement and stabilization of the shoulder joint:
- Supraspinatus, which helps move the arm away from body
- Infraspinatus, which aids in the arm's external rotation
- Subscapularis muscle, which aids in the arm’s internal rotation
- Teres minor, which aids in the arm's external rotation
Every day, these shoulder tendons and muscles are put under a lot of strain. Cleaning, painting, gardening, lifting boxes, and even recreational activities like golf, tennis, and swimming can cause shoulder tendon strain or tear.
How is a shoulder tendon tear diagnosed?
Diagnosis of a shoulder tendon tear may begin with taking your medical history and performing a physical examination. During the examination, your doctor may:
- Look for areas of discomfort or pain in the shoulder
- Examine the shoulder joint's range of motion and strength
An X-ray and a magnetic resonance imaging (MRI) scan may be ordered if a rotator cuff tear is suspected. Your doctor will rule out other disorders that can produce similar symptoms, such as a pinched nerve in the neck or shoulder arthritis.
Who is at risk of a shoulder tendon injury?
Shoulder injuries can happen to anyone, whether from falling on an outstretched arm, direct impact, or repetitive overuse. However, some factors may increase your risk of shoulder tendon injury:
- Age: Older people are at higher risk of wear and tear due to the degenerative weakening of soft tissue. Degenerative disorders usually start at age 40 and become more common with age.
- Jobs: Repetitive exertion of the shoulder can cause tiny tears in the soft tissue, and this damage can worsen over time. Construction workers, painters, and athletes are at greater risk of getting injured this way.
- Smoking: Smoking reduces the flow of blood and oxygen to the body's soft tissues, increasing the susceptibility to injury and slowing the healing process. Smoking can also make it difficult to strengthen muscles and prevent future injuries.
What are treatment options for rotator cuff tears?
Tendon tears range in size from microscopic injuries to complete ruptures in which the tendon is completely torn from the bone. Furthermore, sometimes the initial injury results in a secondary tear.
Mild to moderate tears
If you suspect a rotator cuff tear, speak to an orthopedic expert. They may recommend the following treatment for mild to moderate tendon injuries.:
- Anti-inflammatory medications
- Steroid injections
- Physical therapy
In some cases, a combination of rest, conservative treatments, and patience is enough to help a tear heal on its own. A mild tear usually heals in 6-8 weeks, but a more serious tear may take up to 12 weeks to heal.
Surgery may be needed in severe cases, especially for athletes or people who work in construction:
- Arthroscopic surgery is used to treat a partial or complete tear of the rotator cuff tendon.
- For difficult tears, open surgery (with a larger incision) may be required.
- After surgery, it's critical to immobilize the shoulder and gradually begin rehabilitation exercises to regain shoulder strength.
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Weerakkody Y, Jha P. Rotator Cuff Tear. Radiopaedia. https://radiopaedia.org/articles/rotator-cuff-tear
Spectrum Health. Shoulder Tendon Tear. https://www.spectrumhealth.org/patient-care/orthopedics/shoulder-conditions/tendon-tear
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