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Rotator Cuff Tear: Symptoms & Recovery
804K views
Feb 19, 2024
We delve deep into understanding the rotator cuff, a crucial group of muscles and tendons that provide stability and movement to the shoulder joint. Whether you're an athlete, someone engaged in physical labor, or experiencing shoulder pain, this video is tailored for you.
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rotator cuff tear symptoms, causes, and recovery
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If you felt a painful pop in your shoulder during that pick-up basketball game
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or find basic motions like brushing your hair increasingly difficult, you may be dealing with a rotator cuff injury
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These small, overlooked muscles play a huge role in keeping your shoulder stable and mobile
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Let's explore why rotator cuff tears are so common, how to know if you have one
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and the best treatments to get back to pain-free movement. But before we continue, we would like you guys to subscribe to the channel
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Anatomy of Rotator Cuff Before diving into injury specifics, let's quickly overview the structure and purpose of the rotator cuff
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Knowing the anatomy helps this group of muscles make more sense. The rotator cuff refers to four separate muscles and tendons that stabilize the shoulder joint
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particularly the humeral head of the upper arm bone. The four muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis
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Their tendons gradually converge to form one thick rotator cuff tendon that secures around the front, top, and back of the humeral head
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This cuff-shaped tendon complex holds the ball of the humerus securely within the shoulder socket
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as we move our arms in all directions. Why does this matter
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Well, the shoulder joint is the most mobile joint in the entire body
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The elaborate architecture allows us to swing our arms overhead to throw a ball
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out to the side to cradle a baby, behind the back to clasp a bra strap
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and all sorts of ranges in between. But with great mobility comes vulnerability
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Because the shoulder joint relies heavily on soft tissues like muscles and ligaments for stability
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rather than a deep socket like the hip, it depends on the dynamic stabilization of the rotator cuff
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This is why rotator cuff injuries that damage the tendons or muscles can be so debilitating
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Even small tears lead to pain, weakness, and restricted movement. If the rotator cuff can't hold the humeral head in place properly
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the shoulder joint functions poorly. Now that we understand the critical role of this muscle and tendon group
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let's explore how do you know if you possibly have a torn rotator cuff
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Signs and Symptoms There are some common red flags to pay attention to
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Rotator cuff tears can range from partial thickness tears where the tissue is frayed
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to full thickness tears where the tendon completely pulls away from the bone
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The most typical symptom is shoulder pain, especially when lifting or lowering your arm
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You may notice the pain at night when lying on the affected shoulder
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There may be tenderness or swelling around the shoulder joint. As the tear worsens, you might feel weakness in the arm and shoulder
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making daily activities like brushing your hair or reaching overhead challenging. You may also experience a cracking or popping sensation when moving the arm
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Typically, the pain is focused on the front or side of the shoulder, although sometimes pain can radiate down the arm as well
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If these symptoms sound familiar, it's a good idea to see an orthopedic doctor who can properly
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evaluate if a rotator cuff tear is present through a physical exam and potential imaging tests
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like an MRI. Causes and risk factors So what leads to tears in this critical shoulder tissue
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There are certain factors that raise your vulnerability. Repetitive shoulder movements, especially overhead, create wear and tear over time
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Think baseball pitchers, painters, warehouse workers. Sports like tennis, weightlifting, and volleyball that involve forceful or
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repetitive overhead motions also up the risk. As we age, the tendons lose elasticity and are more prone to small tears that expand over time
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Most rotator cuff tears actually happen to people in their 50s or 60s
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Various shoulder injuries or surgeries can predispose you as well. Bone spurs and arthritis that develop in the shoulder region can rub against and irritate
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the rotator cuff. Anatomical factors that narrow the space the rotator cuff tendons pass through
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like having a curved acromion bone, can lead to tendon fraying. Some people are just born with tendons that are more susceptible to damage
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And finally, acute trauma like taking a hard fall can certainly cause sudden rotator cuff tears
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For all these reasons, rotator cuff tears are very common. The good news is, even full thickness rotator cuff tears have very high healing rates if
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addressed properly through conservative or surgical treatment. Catching and treating early tears before they expand leads to the best outcomes
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Conservative treatment options If you've been diagnosed with a partial or full rotator cuff tear, the first line of
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treatment is usually conservative care to see if the tendon can heal on its own
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The main goals are to reduce inflammation, alleviate pain, prevent stiffness, gently
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stimulate blood flow for healing, and slowly rebuild strength. Your doctor will likely recommend a period of rest to calm shoulder inflammation
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especially if there was a traumatic injury. This may involve wearing a sling and avoiding activities that aggravate your symptoms
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While total rest was once prescribed, we now know gentle movement helps facilitate healing
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so complete immobilization is not advised. You'll need to temporarily stop any activities, sports, or repetitive arm motions that trigger
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your shoulder pain until the tendon starts to recover. Your doctor or physical therapist can guide you on what motions to specifically avoid
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based on your injury. This may mean taking a break from sports like tennis, swimming, weightlifting, or golf for
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a period of time. Work tasks requiring forceful overhead reaching may also need adjustment
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Icing the shoulder for 15, 20 minutes several times per day can relieve acute pain in the
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Once inflammation subsides, many patients find regular heat packs helpful to stimulate
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blood flow and relax the tissues. Use whichever modality provides you the most symptom relief
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Over-the-counter anti-inflammatory medication like Advil or Aleve can ease rotator cuff tear discomfort
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Topical pain-relieving creams containing ingredients like diclofenac gel or capsaicin can provide
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localized relief as well. Corticosteroid injections may also be warranted short-term for severe pain, but may negatively
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impact long-term healing. Evidence shows supplements like vitamin C, zinc, turmeric, omega-3s, and avocado-soybean
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unsaponifiables may support soft tissue healing. Check with your doctor before starting new supplements, especially if you take other medications
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PT focuses first on gentle shoulder stretches. PT focuses first on gentle shoulder stretches, mobilizations, and range of motion exercises
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to prevent adhesive capsulitis or joint stiffness. As symptoms improve, your therapist will progress rotator cuff and scapula strengthening with
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resistance bands and light, free weights. The goal is to gently stimulate blood flow and stabilize the shoulder girdle until the
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torn tendon can heal. Home exercises will supplement in-clinic sessions. The right conservative program can lead to successful healing of partial thickness and
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some full thickness tears. Commit to the rehab process for at least 3, 6 months before determining if surgery may
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be the next step. With small tears, the majority heal without operative intervention
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Listen to your body and health care team. Surgery for Rotator Cuff Repair
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If conservative treatment fails to alleviate pain or get the tear healing after 3, 6 months
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surgery may be the next best step. Traditional open surgery with large incisions has been replaced by less invasive arthroscopic
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techniques with faster recovery times. The surgery usually involves debriding frayed tissue, reattaching the separated tendon back
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to the bone with suture anchors, and often patching larger tears. Rehabilitation progresses gradually after surgery to allow the repair to fully heal
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before loading fully. For young active patients with traumatic tears, surgery within the first few months
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leads to high healing rates and patient satisfaction. In older patients, surgical outcomes are more mixed depending on tear chronicity and tissue
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quality, but still help improve comfort and function. Talk with your surgeon about realistic expectations. Complications
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While most patients with rotator cuff tears heal successfully, there are potential complications
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to be aware of. Knowing these risks guides treatment decisions and helps set realistic expectations
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A torn rotator cuff can progress over time if left untreated. Partial thickness tears may expand into full thickness tears, leading to greater dysfunction
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Significant retraction where the tendon pulls away from the bone also lowers repair success rates
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Chronic tears often form scar tissue and muscle atrophy, which are more difficult to fix surgically
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Complications can also deteriorate in overall quality and become stiff, restricting smooth
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shoulder motion. Frozen shoulder, also called adhesive capsulitis, develops if the joint is immobilized too long
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This leads to thickened capsule tissue reducing shoulder mobility. While therapy helps regain flexibility, range of motion may never fully return to normal
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Rare complications from rotator cuff surgery and repairs include infection, nerve injury
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continued weakness, tear re-rupture, and complex regional pain syndrome. Smokers and those with diabetes have higher complication risks. Prevention
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While it's impossible to prevent all rotator cuff tears, there are measures you can take
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to reduce your risk. Stretch and strengthen the rotator cuff muscles regularly to keep tendons flexible and resilient
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Maintain posture and scapular stability with exercises targeting the upper back. Warm up properly with light cardio and arm circles before training or competing in overhead
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sports to prep connective tissues. Cool down and stretch thoroughly afterward. Use sound biomechanics when weightlifting to prevent overuse, fatigue, and injury
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Focus on controlled form rather than heavy lifting with momentum. Listen to early warning signs like shoulder soreness after activity
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Adjust your training if pain lingers more than one, two days. Taking adequate rest periods allows overuse injuries to heal
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Implementing healthy lifestyle habits like nutrition, sleep hygiene, and stress management supports overall musculoskeletal health and immunity
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While you can't prevent natural age-related degeneration, proactively caring for your shoulder through activities that strengthen without overuse sets you up for success
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As you can see, rotator cuff tears are quite common and responsible for millions of doctor
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visits annually. But with the right treatment plan and commitment to rehab, healing and return to function are
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very possible. Catching minor shoulder pain early and adjusting activities helps prevent small, partial tears
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from expanding over time as well. Now, we'd love to hear from you in the comments
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Have you dealt with shoulder discomfort before? What treatment methods worked best to resolve your pain
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Do you have any rehab tips to share that helped you through recovery
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