Torn
Rotator Cuff
What
Is a Torn Rotator Cuff?
One or more rotator
cuff tendons may become inflamed from overuse, aging, a fall
on an outstretched hand, or a collision. Sports requiring repeated
overhead arm motion or occupations requiring heavy lifting also
place a strain on rotator cuff tendons and muscles. Normally
tendons are strong, but a longstanding wearing down process
may lead to a tear.
What
Are the Signs of a Torn Rotator Cuff?
Typically, a person
with a rotator cuff injury feels pain over the deltoid muscle
at the top and outer side of the shoulder, especially when the
arm is raised or extended out from the side of the body. Motions
like those involved in getting dressed can be painful. The shoulder
may feel weak, especially when trying to lift the arm into a
horizontal position. A person may also feel or hear a click
or pop when the shoulder is moved.
How
Is a Torn Rotator Cuff Diagnosed?
Pain or weakness
on outward or inward rotation of the arm may indicate a tear
in a rotator cuff tendon. The patient also feels pain when lowering
the arm to the side after the shoulder is moved backward and
the arm is raised. A doctor may detect weakness but may not
be able to determine from a physical examination where the tear
is located. X rays, if taken, may appear normal. An MRI can
help detect a full tendon tear, but does not detect partial
tears. If the pain disappears after the doctor injects a small
amount of anesthetic into the area, impingement is likely to
be present. If there is no response to treatment, the doctor
may use an arthrogram, rather than an MRI, to inspect the injured
area and confirm the diagnosis.
How
is a Torn Rotator Cuff Treated?
Doctors usually recommend
that patients with a rotator cuff injury rest the shoulder,
apply heat or cold to the sore area, and take medicine to relieve
pain and inflammation. Other treatments might be added, such
as electrical stimulation of muscles and nerves, ultrasound,
or a cortisone injection near the inflamed area of the rotator
cuff. The patient may need to wear a sling for a few days. If
surgery is not an immediate consideration, exercises are added
to the treatment program to build flexibility and strength and
restore the shoulder's function. If there is no improvement
with these conservative treatments and functional impairment
persists, the doctor may perform arthroscopic or open surgical
repair of the torn rotator cuff.
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