Rotator cuff tear
What is a rotator cuff tear?
One or more of the rotator cuff muscles/tendons (supraspinatus, infraspinatus, subscapularis) can rupture (break) partially or completely. It can happen acutely, for example in a fall where you catch yourself with your arm, or if you experience a jerk in your arm. It can also occur in older patients because the rotator cuff has degenerated, i.e. the circulation and elasticity in the muscle/tendon has gradually deteriorated over the years, which leads to a fragile tendon, muscle tissue that can more easily cause a rotator cuff tear.
Symptoms of a rotator cuff tear
In acute rotator cuff rupture, sudden pain often occurs with difficulty lifting and turning the arm. Often, there is pain in the front of the shoulder or the outside of the upper arm. Sometimes, you may experience a snapping sensation in the shoulder at the time of the accident. You may also feel weakness in the arm. As for the older, fragile rotator cuff (degenerative), the symptoms can be similar to those of impingement and the muscle breaks through abrasion against the overlying bone edge, the acromion, or a jerk in the arm. Once the rupture occurs, sudden pain and weakness in the arm may occur. In this case, too, you may experience a snapping sensation in the shoulder when it occurs. In some cases, it is not painful, but rather weakness and impaired function that cause the patient to seek help.
Treatment for rotator cuff rupture or partial rupture
Through manual examination, we can see with relative certainty whether a major rotator cuff tear has occurred or not. With ultrasound diagnostics, we see the extent of the injury in detail, what is torn and what is not. Acute total rupture of one or more tendons is often operated on and a gradually increased exercise rehabilitation follows after a period of fixation of the arm to the body. The degenerative rupture is often difficult to get in order with surgery. If the orthopedist has concluded that surgery is not necessary, we must focus on optimizing the function of the shoulder with the remaining, functioning muscles using a gradual exercise rehabilitation .
In the case of partial ruptures where a majority of the tendon remains in place, the tendon is not operated on. To reduce pain and swelling in the shoulder, an ultrasound-guided cortisone injection may be an alternative. After that, or in cases where no injection is given, a gradually increased exercise rehabilitation begins, often in combination with manual therapy.
