What Causes a Rotator Cuff Tear?
As the name suggests, a rotator cuff tear is a tear of your shoulder’s rotator cuff tendons. These tears can occur in two ways:
- Trauma: Traumatic rotator cuff tears occur suddenly, caused by a high force going through the tendon that pushes it beyond its limit. This is usually the result of a heavy load, such as a forceful throw, a fall onto an outstretched hand, as well as heavy pushing, pulling or lifting.
- Repeated Micro-trauma: This is the more common cause of rotator cuff tears. These kinds of tears develop over weeks or months, through repeated straining or pinching of the rotator cuff tendons. These injuries often occur in athletes involved in swimming, weight lifting, racquet sports, throwing sports such as baseball, or paddling sports such as rowing. In non-athletes, micro-trauma can be caused by repeated pushing, pulling, lifting, or overhead activities.
One of the most common symptoms of a rotator cuff tear is pain over the top of the shoulder and arm. This pain may extend down the outside of the arm and be present during both activity and rest. Another frequent symptom is shoulder weakness, particular when lifting your arm up overhead. You may also notice a clicking or crackling sensation when moving your shoulder in certain positions. Depending on the severity of the tear, these symptoms may be mild or they may be severe enough to interfere with everyday activities.
Treatment of rotator cuff tears and the effectiveness of surgical intervention are often debated among health care professionals. A recent study from Finland suggests that physiotherapy alone can be equally as effective in treating rotator cuff tears as arthroscopic surgery and open surgical repair. In this study, 167 patients with non-traumatic tears of the supraspinatus tendon were followed for one year as they received different treatments. The result was that the patients who received physiotherapy alone showed similar rates of improvement compared to those who received surgery. This indicates that surgery may not be necessary in many cases, and physiotherapy can be effective as the primary treatment for rotator cuff tears.
This can seem a little confusing at first. How can a rotator cuff tear heal without surgery to actually close the tear? It’s possible because the tear does not necessarily have to be repaired for patients to experience pain relief, restored mobility, and increased strength. In fact, research has shown that 30% of people under age 70, and 70% of people over age 80, actually have a rotator cuff tear, yet experience no symptoms. Therefore, the tear itself is not a problem, only the symptoms associated with it; and these symptoms can be resolved through physiotherapy.
Common treatment techniques for rotator cuff tears include:
- Soft tissue massage
- Joint mobilization
- Ice or heat treatment
- Progressive exercises to improve strength and flexibility
- Technique correction and education
Treatment is most effective if begun as soon as possible after the injury, and therefore it’s important to seek treatment right away if you suspect you may have sustained a rotator cuff tear. The professional team at Spectrum Physiotherapy can assess your shoulder symptoms, work with you to develop a treatment plan, and guide you along the road to recovery.