Rotator Cuff Tears

What is a rotator cuff tear?

A rotator cuff tear is an injury to the group of muscles and tendons that surround your shoulder joint. These muscles and tendons help keep your arm bone (humerus) in the shoulder socket and allow you to lift and rotate your arm. When one or more of these tendons is torn, it can cause pain and weakness in your shoulder.

At Blacktown Health, our team of Physiotherapists, Chiropractors, and Exercise Physiologists in Blacktown often see patients with rotator cuff tears, and understand how they can impact your work and life. So we've put together this guide so you can better understand what rotator cuff tears are, and what treatments you can do to get them better.

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What are the symptoms of a rotator cuff tear?

The symptoms of a rotator cuff tear can vary depending on the severity of the injury. Common signs include:

• Pain in your shoulder, especially when lifting or lowering your arm
• Weakness when lifting or rotating your arm
• A crackling sensation (crepitus) when moving your shoulder
• Difficulty sleeping on the affected side
• Pain that radiates down your arm
• Stiffness in your shoulder

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What causes rotator cuff tears?

Rotator cuff tears can be caused by many things such as:

• Injury: A sudden, forceful movement can cause an acute tear
• Degeneration: Wear and tear over time can lead to a tear, especially in older adults
• Repetitive stress: Certain jobs or sports that involve repeated overhead arm movements
• Bone spurs: These can rub against the rotator cuff tendon, causing it to weaken and tear
• Poor blood supply: As we age, blood supply to the rotator cuff tendons decreases, making them more vulnerable to injury

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How are rotator cuff tears diagnosed?

When you visit Blacktown Health with a suspected rotator cuff tear, our healthcare professionals will use several methods to diagnose your condition:

• Physical examination: Your physiotherapist or chiropractor will check your shoulder's range of motion and strength, and look for specific signs of a rotator cuff tear.
• Medical history: They'll ask about your symptoms, when they started, and how they affect your daily life.
• Special tests: There are specific tests that can help determine if you have a rotator cuff tear, such as the empty can test and the drop arm test.
• Imaging tests: X-rays, ultrasound, or MRI scans may be used to get a closer look at your shoulder joint and confirm the diagnosis.

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What role does imaging play in diagnosing rotator cuff tears?

Imaging tests are important tools for diagnosing and assessing rotator cuff tears. Here's how different types of imaging can help:

• X-rays: While they can't show soft tissue like tendons, X-rays can reveal bone spurs or other bone changes that might be contributing to your pain.
• Ultrasound: This can show the soft tissues of your shoulder, including the rotator cuff tendons. It's a quick and painless way to see if there's a tear.
• MRI (Magnetic Resonance Imaging): This gives the most detailed view of your shoulder, showing both bones and soft tissues. It can reveal the size and location of a tear, which helps in planning treatment.

Our Physiotherapists and Chiropractors in Blacktown can refer you for these scans if necessary and explain what the results mean for your condition and treatment.

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How are rotator cuff tears treated?

Treatment for rotator cuff tears depends on the size of the tear, your age, your activity level, and how long you've had symptoms. These include:

• Rest and activity modification: Avoiding activities that cause pain can help the tendon heal.
• Ice or heat therapy: To reduce pain and inflammation.
• Exercise therapy: Our Physios, Chiros, and EP's can design an exercise program to improve your shoulder strength and flexibility.
• Pain relief: Over-the-counter pain medications or prescription drugs may be recommended to manage pain and inflammation.
• Corticosteroid injections: These can provide temporary pain relief in some cases.
• Surgery: For large tears or when conservative treatments don't work, surgery might be necessary.

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When is surgery required for rotator cuff tears?

Surgery is usually considered when:

• Conservative treatments haven't improved your symptoms after several months
• You have a large tear (more than 3 cm)
• You're young and active
• You need full shoulder strength and function for work or sports
• Your symptoms have been present for 6 to 12 months

The type of surgery will depend on the size and location of your tear. Options include:

• Arthroscopic tendon repair
• Open tendon repair
• Tendon transfer
• Shoulder replacement

If surgery is being considered, our Physiotherapists and Chiropractors in Blacktown can help recommend some good orthopaedic surgeons to perform these procedures and guide you through any post-surgical rehabilitation required afterwards.

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What role does exercise play in treating rotator cuff tears?

Exercise is a crucial part of treating rotator cuff tears, whether you're having surgery or not. It helps to:

• Improve shoulder strength and stability
• Increase flexibility and range of motion
• Reduce pain and inflammation
• Prevent further injury

Our Physiotherapists, Chiropractors, and Exercise Physiologists at Blacktown Health can design an exercise program tailored to your specific needs. This might include:

• Pendulum exercises: To gently increase mobility
• Isometric exercises: To strengthen muscles without moving the joint
• Range of motion exercises: To improve flexibility
• Strengthening exercises: To build up the muscles that support your shoulder

Remember, it's important to start slowly and gradually increase the intensity of your exercises.

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Can rotator cuff tears heal on their own?

Small, partial rotator cuff tears can sometimes heal on their own with proper rest and rehabilitation. However, larger tears or complete tears are unlikely to heal without surgical intervention. Even if a tear doesn't heal completely, many people can manage their symptoms and maintain good shoulder function with conservative treatment.

It's important to note that untreated rotator cuff tears can get larger over time, so early treatment is key.

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How long does it take to recover from a rotator cuff tear?

Recovery time can vary greatly depending on the severity of the tear and the treatment approach:

• For minor tears treated conservatively: You might see improvement in a few weeks, with full recovery in 3-6 months.
• For larger tears requiring surgery: Recovery can take 4-6 months, with some people needing up to a year to regain full strength and function.

Remember, everyone's recovery is different. Factors like your age, overall health, and how well you follow your treatment plan can all affect your recovery time.

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How can I prevent rotator cuff tears?

While you can't prevent all rotator cuff tears, especially those due to ageing, there are steps you can take to reduce your risk:

• Maintain good posture: Poor posture can put extra stress on your shoulder muscles.
• Avoid repetitive overhead activities: If your job or hobbies involve a lot of overhead arm movements, take regular breaks and use proper form.
• Strengthen your shoulder muscles: Regular exercises can help keep your rotator cuff muscles strong and flexible.
• Warm up before physical activities: This can help prepare your muscles for exercise and reduce the risk of injury.
• Stop smoking: Smoking can reduce blood flow to your rotator cuff, making it more prone to injury.
• Maintain a healthy weight: Excess weight can put additional stress on your joints, including your shoulders.

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When should I see a healthcare professional about shoulder pain?

You should consider seeing a healthcare professional if:

• Your shoulder pain persists for more than a few days
• You have significant weakness in your arm or shoulder
• You're unable to raise your arm
• You have pain that disturbs your sleep
• You've experienced a sudden injury to your shoulder

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Take home message

Rotator cuff tears are common injuries that can significantly impact your shoulder function and quality of life. However, with proper diagnosis and treatment, many people with rotator cuff tears can reduce their pain and regain good shoulder function.

At Blacktown Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologists in Blacktown can help you recover from your rotator cuff tear. We offer a range of treatments and can provide personalised advice on exercise, lifestyle modifications, and pain management strategies. Remember, early intervention is key in managing rotator cuff tears.

So if you're experiencing shoulder pain or have concerns about a possible rotator cuff tear, don't hesitate to contact us at Blacktown Health. We have clinics conveniently located around Sydney in Mt Kuring-Gai, Asquith, Willoughby, Milsons Point, Dural, and Blacktown so you can get the right advice and treatment for your rotator cuff tear.

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