Rotator Cuff Tears
A torn rotator cuff is a fairly common injury, as well as a painful one. These tears can occur as either a partial, or total tear, which may or may not require surgical treatment depending upon the severity of the individual case.
Understanding the Rotator Cuff
Shoulder Anatomy
The shoulder is the most mobile joint in the body, allowing you to reach, lift, throw, and perform countless everyday activities. It is made up of three bones: the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle). The ball at the top of the humerus fits into a shallow socket in the shoulder blade, creating the shoulder joint.
What Is the Rotator Cuff?
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint. Together, they keep the ball of the shoulder centered in the socket while providing strength and stability for lifting, reaching, and rotating your arm.
A healthy rotator cuff allows smooth, pain-free shoulder motion and is essential for everyday activities, work, and sports.
What Causes a Rotator Cuff Tear?
Rotator cuff tears can develop suddenly after an injury or gradually over time as the tendon wears down.
Common causes include:
- Age-related wear and degeneration
- Repetitive overhead activities at work or during sports
- Heavy lifting
- Falls or traumatic injuries
- Shoulder dislocations
- Bone spurs that rub against the tendon
- Poor blood supply to the tendon with aging
Although anyone can develop a rotator cuff tear, they become increasingly common after age 40.
Symptoms of a Torn Rotator Cuff
A torn rotator cuff can cause symptoms that range from mild discomfort to significant pain and weakness.
Common symptoms include:
- Pain on the outside or front of the shoulder
- Pain when reaching overhead or behind your back
- Shoulder weakness
- Difficulty lifting objects
- Night pain, especially when lying on the affected shoulder
- Clicking or catching sensations
- Loss of motion
- Difficulty with everyday activities such as dressing, combing your hair, or reaching into cabinets
Some chronic tears may cause weakness with very little pain.
Diagnosing a Rotator Cuff Tear
An accurate diagnosis begins with a thorough evaluation by one of our orthopedic shoulder specialists.
Your evaluation may include:
- A detailed discussion of your symptoms and medical history
- A comprehensive shoulder examination
- Assessment of strength and range of motion
- X-rays to evaluate the bones and identify arthritis or bone spurs
- MRI to evaluate the rotator cuff tendons, tear size, muscle quality, and surrounding structures
- Occasionally ultrasound or CT imaging when appropriate
These studies help determine the severity of the injury and guide the most appropriate treatment plan.
Treatment Options
Treatment is individualized based on your age, activity level, symptoms, overall health, and the size and chronicity of the tear.
Non-Surgical Treatment
Many patients improve without surgery.
Treatment may include:
- Activity modification
- Anti-inflammatory medications
- Physical therapy
- Home exercise programs
- Corticosteroid injections when appropriate
- Platelet-rich plasma (PRP) or other biologic treatments in selected patients
The goal is to reduce pain, improve strength, and restore shoulder function.
Surgical Treatment
When pain persists despite conservative care, or when the tear is large or caused by an acute injury, surgery may provide the best opportunity to restore function.
Our fellowship-trained shoulder surgeons specialize in advanced arthroscopic and reconstructive techniques.
Surgical Treatment Options
Arthroscopic Rotator Cuff Repair
Most rotator cuff tears can be repaired arthroscopically through several small incisions using a tiny camera and specialized instruments. The torn tendon is carefully reattached to the bone using small anchors.
Benefits include:
- Smaller incisions
- Less pain
- Faster recovery
- Lower risk of complications
- Excellent long-term outcomes for appropriately selected patients
Biologic Augmentation
For larger tears or tissue with poor healing potential, biologic augmentation may improve tendon healing.
Depending on the individual patient, this may include:
- Biologic scaffold patches
- Platelet-rich plasma (PRP)
- Advanced biologic technologies designed to enhance healing
Your surgeon will determine whether biologic augmentation may be beneficial for your specific condition.
Superior Capsular Reconstruction (SCR)
Some rotator cuff tears cannot be repaired because the tendon has become too damaged or retracted.
Superior capsular reconstruction is an advanced arthroscopic procedure that uses a graft to restore stability to the shoulder, reduce pain, and improve function while preserving the patient’s own joint.
SCR is often an excellent option for younger, active patients who have an irreparable rotator cuff tear but little or no arthritis.
Muscle Transfer Procedures
In selected patients with massive, irreparable rotator cuff tears, nearby muscles and tendons can be transferred to restore shoulder movement and improve strength.
These highly specialized procedures are typically reserved for younger, active individuals who are not candidates for shoulder replacement.
Arthroscopic Debridement
When a rotator cuff tear cannot be repaired and the primary goal is pain relief rather than restoring strength, arthroscopic debridement may be recommended.
During this minimally invasive procedure, damaged tissue and inflamed tissue are removed, bone spurs may be smoothed, and other painful shoulder conditions can be addressed.
Although this procedure does not repair the torn tendon, it can significantly improve comfort and shoulder function for appropriately selected patients.
Reverse Total Shoulder Arthroplasty
For patients with massive, irreparable rotator cuff tears accompanied by shoulder arthritis or severe loss of function, a reverse total shoulder replacement may provide the most reliable pain relief and restoration of movement.
Unlike a traditional shoulder replacement, a reverse shoulder replacement changes the mechanics of the joint, allowing the larger deltoid muscle to compensate for the damaged rotator cuff.
This procedure has become one of the most successful treatments for advanced rotator cuff deficiency and can dramatically improve pain, strength, and quality of life.
Expert Shoulder Care at Midwest Orthopedic and Musculoskeletal Alliance
At Midwest Orthopedic and Musculoskeletal Alliance, our fellowship-trained shoulder specialists provide comprehensive care for every type of rotator cuff injury—from simple tendon inflammation to the most complex irreparable tears.
Using the latest imaging technology, advanced arthroscopic techniques, biologic treatments, and reconstructive procedures, we develop individualized treatment plans designed to relieve pain, restore function, and help you return to the activities you enjoy as quickly and safely as possible.
Schedule Your Rotator Cuff Consultation
To speak with a specialist about your rotator cuff injury or ways to prevent future damage to your shoulders, contact Midwest Orthopedic and Musculoskeletal Alliance today at 414-384-6700. Our team in Southeastern Wisconsin is ready to help.