Rotator cuff tears are a common problem that become more frequent and serious as you age. People with shoulder pain often wonder, “Do I have a rotator cuff tear?” They’re unfamiliar with symptoms of a rotator cuff tear, how they are diagnosed and what treatment options are available, often asking, “Will I need surgery?” In this article, we’ll address some of those questions.
The rotator cuff is a group of muscles and tendons that surround the shoulder joint. It helps keep your arm firmly within your shoulder socket and stable as you lift and rotate it.
The rotator cuff steers the force produced by the large shoulder muscles (called the deltoid), much like the steering wheel in a car directs the power of the engine. Without the rotator cuff, the larger shoulder muscles cannot work effectively when moving or lifting.
Symptoms of rotator cuff tears
A rotator cuff tear can make normal activities suddenly become difficult and painful. Torn rotator cuff symptoms include:
- Deep aching in the shoulder, especially at night
- Pain and weakness reaching up or lifting objects overhead
- Pain when reaching behind your back
- Weakness when rotating or raising your arm outward
If these symptoms sound familiar, give us a call today for a free consultation. We’re here to help!
What causes rotator cuff tears
Many times, rotator cuff tears occur with no clear reason. It can result from chronic, long term stress on the rotator cuff due to tightness, weakness, or imbalance of movement in the shoulder (called rotator cuff impingement). In fact, the stress on the rotator cuff often continues for years with only mild pain.
Some factors that can increase the risk of a rotator cuff tear include:
- Normal wear and tear, typically for people over 40
- Repeating the same motion over and over (like swinging a hammer)
- Constantly doing overhead work (such as painting ceilings)
- Repeated heavy lifting, pulling or pushing
- Falling
In addition, the bony structure of the shoulder can contribute to pinching the rotator cuff. Medical problems, such as diabetes and thyroid issues, can also increase the potential for rotator cuff tears.
How rotator cuff tears are diagnosed
Here at Excel Physical Therapy, rotator cuff tears are diagnosed by examining each patient as a whole. Our physical therapists do a detailed evaluation of all your symptoms, along with a thorough examination of your shoulder movement and strength. Special tests are also performed to help identify specific problems. What’s more, we take into consideration other sources of shoulder pain in addition to your rotator cuff tear, including arthritis, frozen shoulder or a pinched nerve in the neck.
If your shoulder problem is severe or not improving appropriately with treatment, our physical therapists may also refer you for X-Rays or to an orthopedic physician for further examination and an MRI.
Exercises for a rotator cuff tear
Many people hear “rotator cuff tear” and immediately think surgery is needed. However, recent studies show that physical therapy can often be an effective treatment for small, medium and even large tears. Our physical therapists work with orthopedic surgeons to determine when surgery is needed.
Many people with rotator cuff tears can eliminate pain and regain movement and strength of their shoulder with a rotator cuff physical therapy plan. In fact, the International Journal of Sports Physical Therapy noted that conservative treatment is effective in 73–80% of patients. As part of that treatment plan, we may recommend several exercises to help relieve pain and restore range of motion.
However, these exercises need to be performed under the medical advice and oversight of a physical therapist. They’re meant to be included as just one part of an individualized treatment plan. Your specific rotator cuff injury may require different or additional exercises, as well as other treatment options. (If you have questions about shoulder physical therapy, visit our FAQ shoulder page.)
As listed by the American Academy of Orthopaedic Surgeons, recommended exercises may include:
The Pendulum (This is an easy exercise to do if your shoulder is painful.)
- Lean forward and place one hand on a counter or table for support. Let your other arm hang freely at your side.
- Gently swing your arm forward and back. Repeat the exercise moving your arm side-to-side and repeat again in a circular motion.
- Repeat the entire sequence with the other arm.
Passive Internal Rotation
- Hold a stick or towel behind your back with one hand, and lightly grasp the other end of the stick or towel with your other hand.
- Pull the stick or towel horizontally as shown so that your shoulder is passively stretched to the point of feeling a pull without pain.
- Hold for 30 seconds and then relax for 30 seconds.
- Repeat on the other side.
The Crossover Arm Stretch
- Relax your shoulders and gently pull one arm across your chest as far as possible, holding at your upper arm.
- Hold the stretch for 30 seconds and then relax for 30 seconds.
- Repeat with the other arm.
If you’re ready to get a personalized treatment plan designed to help heal your rotator cuff tear as fast as possible, give us a call or schedule an appointment today.
Get back to living life freely
When you schedule an appointment at Excel Physical Therapy, we not only assess your injury, but also what may have caused it and what your normal day-to-day activities are so we can get the full picture.
This assessment involves testing of the specific structures of the shoulder. It includes testing and evaluating the quality, control and balance of motion and strength of other nearby areas of your body that could also be producing pain (such as your neck or arm).
After assessing you, our physical therapists will develop an individualized treatment plan for your rotator cuff. This may include appointments with your physical therapist and exercises at home, so you can get back to enjoying life—and lessen the chance of future injury.
Set up an appointment today for a personalized treatment plan designed to help you live life the way you want to.
