A rotator cuff tear is a common problem that makes routine activities uneasy and painful. Yet, many therapists, chiropractors included, say rotator cuff tear treatment is one of the most difficult to tackle.
The rotator cuff is the name for a group of four tendons and muscles surrounding the shoulder joint. This important group of muscles that gives support and stability to the rotator cuff. It helps the shoulder joint to function via a wide range of motions so we can perform different tasks with our arms. The rotator cuff allows the shoulder joint to move and turn through a wider range than the body’s other joints.
Too much stress on that area can cause swelling and partial tears in the tendons of the rotator cuff. Abrupt stress may sometimes lead to one of the tendons pulling away from the bone or tearing in the middle of the tendon.
Estimated average age of rotator cuff tear onset
The estimated average age of onset varies depending on the source, but generally it is believed to occur most commonly in people over the age of 40. Some studies have suggested that the prevalence of rotator cuff tears increases with age, with the risk of tears increasing significantly after the age of 60.
However, it’s important to note that a rotator cuff tear can occur in younger individuals as well, particularly if they engage in repetitive overhead motions or participate in sports that require a lot of throwing or overhead movements. In these cases, the tear may be caused by overuse or a sudden injury rather than age-related degeneration.
Autopsy studies of rotator cuff tears
Autopsy studies of rotator cuff tears have shown that 28% of people had partial tears, and 30% had a complete rupture. This is a pretty significant number that suggests that rotator cuff tears don’t always have painful symptoms or cause disability and, therefore, may go unnoticed for awhile. Females are more likely to have tears and the frequency increases with age. Often, tears occur on both sides. Under the age of 40, rotator cuff tears are rare unless you are an athlete. In sports, baseball, swimming, tennis and football are prone to causing rotator cuff tears.
RANGE-OF-MOTION TESTING VS X-RAYS TO DETECT ROTATOR CUFF TEAR?
As the first point of departure, your doctor will perform a series of range-of-motion tests evaluating your rotator cuff, including:
- Apley Scratch Test: the patient would touch inferior and superior aspects of opposite scapula
- Drop-Arm Test: the patient slowly lowers the arm to waist
While X-rays can identify cracks, chips or other problems with bones, they cannot detect soft tissue injuries such as rotator cuff tears. The following special tests may be used to discover your condition:
- an Arthrogram, a special type of X-ray or MRI where a dye is injected into joint, which allows your doctor to see the damage in more detail.
- Diagnostic ultrasound is a well tolerated and cost-effective procedure. Its disadvantage is a reduced sensitivity in obese patients or those whose shoulder movement is severely restricted. Read this ultrasonography for rotator cuff article for further info.
- an MRI (magnetic resonance imaging) are required to determine if there is a tear in the rotator cuff. In MRI studies of individuals (of any age) showing no symptoms, 34% displayed rotator cuff tears. 26% of those older than 60 years, showed partial thickness tears, and 28% demonstrated full-thickness tears.
- Arthroscopy, a minimally invasive surgical procedure that requires a tiny camera being inserted into the shoulder joint to get a look at the rotator cuff. This additional procedure is usually not performed unless it is likely that a surgical repair is needed as suggested following other non-surgical tests.
There are several rotator cuff tear treatment options. When identifying the best treatment for you, your doctor will consider factors such as your age, general health, activity level, and the type and severity of tear (partial or full-thickness) you have.
Because there is no evidence of better and longer lasting results from surgery performed shortly after the injury or later on, nonsurgical rotator cuff tear treatment methods are usually recommended first.
NONSURGICAL ROTATOR CUFF TEAR TREATMENT
Nonsurgical rotator cuff tear treatment methods show effectiveness in pain relief and shoulder function improvement in about 50% of patients. Options may include:
REST. Likely the most doctor recommended option is to limit overhead arm movements.
SLING. To help restrict the movement of and to protect your shoulder.
ACTIVITY ALTERATION. Avoid activities (especially sports) that require overhead movements and cause shoulder pain.
NON-STEROIDAL ANTI-INFLAMMATORY MEDICATION. Over-the-counter drugs like ibuprofen and naproxen help reduce pain and swelling. Remember that prolonged use of OTC chemical drugs may be toxic for your body so try to limit their use and consider more natural alternatives.
PHYSIOTHERAPY. Learning the exercises that stretch and strengthen the shoulder, as carefully selected by your therapist, can help reduce pain and improve the shoulder’s flexibility.
WHOLE BODY CRYOTHERAPY. Studies have shown that Whole Body Cryotherapy treatment sessions help to reduce inflammation and swelling while oxygenating the blood and boosting pain-reducing endorphins. When combined with exercises and activity alteration (until recovery), Cryosauna may be a very effective rotator cuff tear treatment option. It is widely used by professional athletes worldwide for as sports injury therapy. Influencers Tony Robbins and Joe Rogan use it on a regular basis to boost their immune system. Our Cryotherapy Toronto service had been featured on various media channels including The Social talk show!
EXERCISES. Stretches and range of motions will improve flexibility, strengthen the muscles and help restore movement in the shoulder. Consider doing yoga as it offers many exercises that will strengthen your rotator cuff along with the rest of the body.
STEROID INJECTION. Cortisone and local anesthetic injections may be an effective anti-inflammatory option if physical therapy, meds and rest don’t relieve pain. However, remember that steroid based medications are quite toxic for your body with potential long term negative effects, so resort to this option only when absolutely needed.
PRO’s of nonsurgical rotator cuff tear treatment methods:
- Infection
- Anesthesia complication
- Permanent stiffness
- Potentially lengthy recovery time
CON’s of nonsurgical rotator cuff tear treatment:
- Little to no improvement in shoulder strength
- Tear size may increase over time
- Limitations to routine activities may be required
SURGICAL ROTATOR CUFF TEAR TREATMENT
If you lead a very active lifestyle or do sports or activities that require overhead use of arms, you may also consider surgery. Signs for surgery candidacy include:
- Continued shoulder pain (main indicator)
- Your pain symptoms lasted 6-12 months
- You have a large tear over 3 cm long
- You have significant and bothersome loss of shoulder function
- You have significant weakness in the shoulder
- Your cuff tear was a result of a recent acute injury
Rotator cuff tear surgery usually involves re-attaching the torn tendon to the head of humerus (upper arm bone).
Your orthopaedic surgeon will identify the best procedure for your individual health needs.