The rotator cuff is made up of four muscles (subscapularis, supraspinatus, infraspinatus, and teres minor) that help move and stabilize the shoulder joint. These muscles and their tendons connect your upper arm bone (humerus) with your shoulder blade (scapula).

When any one these muscles or tendons tears this is considered a rotator cuff tear. Torn rotator cuffs are common rotator cuff injures.

What causes rotator cuff tears?

Torn rotator cuffs can occur from sudden jerking movements, falling on an outstretched hand, or lifting something that is too heavy. Tears can also be a result of other shoulder injuries, such as a dislocated shoulder or a fractured (broken) collarbone.

Rotator cuff tears are also wear-and-tear injuries, resulting from repetitive stress on the shoulder's tendons and muscles. Tendons degenerate from use over time, and are more common as we age. Therefore, individuals over 40 years of age are at risk for torn rotator cuffs.

Individuals who also overuse their shoulder muscles, like weightlifters, and those who do repetitive overhead activities, such as painters and carpenters, are also at risk.

What do rotator cuff tears feel like?

Rotator cuff tears are characterized by:

• Pain when lifting or lowering the affected arm
• Tenderness
• Weakness when lifting or rotating the affected arm
• Instability
• Loss of range of motion in the shoulder
• Discomfort when sleeping on the affected shoulder
• A cracking sensation when moving the affected shoulder in certain positions

How do I know if I have a rotator cuff tear?

A physical examination of the shoulder, with focus on its range of motion and assessment of arm strength, will allow your doctor to determin if you have a torn rotator cuff. Your doctor may also use x-ray or magnetic resonance imaging (MRI) to view the rotator cuff muscles and rule out underlying conditions such as arthritis, pinched nerves, or fracture.

What are rotator cuff tear treatments?

If you have a torn rotator cuff, ignore the pain, and keep using your injured shoulder, you may cause further injury to yourself.

Your Duke Orthopaedics specialist will consider many factors including your general health, age, activity level, and the type of tear you have when tailoring your rotator cuff tear treatment.

Typically, nonsurgical treatment options are offered before considering surgical treatment options. Torn rotator cuff treatment options can relieve pain and improve function in the shoulder:

• Steroid injections and anti-inflammatory medicine: Relieving the pain and inflammation associated with rotator cuff tears
• Activity modification: Avoiding activities that can irritate the injured shoulder
• Rest: Limiting overhead activity and immobilizing the injured shoulder -- perhaps by use of a sling
• Physical therapy: Therapeutic exercise designed to strengthen the shoulder muscles and improve range of movement

Though less invasive treatments can help improve shoulder function, shoulder strength does not usually improve without rotator cuff tear surgery.

At Duke, we typically offer rotator cuff tear surgery as an arthroscopic surgery where surgeons inspect and reattach torn tendons in the shoulder's rotator cuff.

Duke Orthopaedics offers rotator cuff treatments at locations convenient to Raleigh, Durham, Cary, and Chapel Hill, North Carolina.

Torn Rotator Cuff Treatment Videos

Rotator Cuff Tears

Watch an educational video about rotator cuff tears and treatment options, including rotator cuff tear surgery, for this condition.

Arthroscopic Rotator Cuff Repair

At Duke Orthopaedics, our doctors often treat torn rotator cuffs with arthroscoptic rotator cuff repair surgery. The following video demonstrates this procedure.