Rotator cuff tear
Diagnosis of rotator cuff tear
The first step of diagnosis for rotator cuff injuries is typically a physical exam, during which your doctor will check your range of motion and look for signs of trauma in your shoulders, such as swelling, warmth, and pain. He or she will likely also ask you to describe how and when your symptoms began.
Because a rotator cuff injury is an injury to the soft connective tissues in the shoulder, this kind of damage typically does not appear on an x-ray, which is used to diagnose broken bones (fractures). X-rays can reveal bone spurs or other conditions that may cause shoulder pain, such as stress fractures.
Ultrasound or MRI scans are often the best tool to show tendons and other soft tissues. After determining that you have a rotator cuff injury, your doctor will check the degree of tearing and which tendons or other structures are affected.
Continuing to use your shoulder despite the pain of a rotator cuff tear can make the damage worse. Treatment starts with resting the shoulder as soon as possible . Early intervention can keep the injury from getting worse and get you back to an active lifestyle quickly. Continuing to work out or engage in other activities with a torn rotator cuff can increase the size of the tear.
Along with rest, your doctor may recommend taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin). These medicines reduce pain as well as inflammation, which helps the tissue heal.
Physical therapy can also help by strengthening the muscles that support your shoulder and restoring movement. Corticosteroid injections are sometimes necessary as well.
The vast majority of shoulder injuries can be healed without surgery. However, if six to 12 months of conservative or nonsurgical treatments fail to relieve your symptoms, surgery may be needed to repair the tendon or reattach it to your humerus (arm bone). Surgery may also be required if your injury is the result of a severe, acute trauma that restricts the use of your arm. Your surgeon will recommend the best treatment method for you.
Most mild rotator cuff injuries heal within two weeks to a month, given time to rest and recover.
If you have an acute injury, or severe tendonitis, you may need a few more weeks or even months. It is common for injuries to happen again (reoccur). You may need to discuss follow-up care with your doctor, such as physical therapy and temporarily restricting your activities to prevent further injury.
If you experience an injury that requires surgery, it may take several months to heal fully. Your doctor will instruct you regarding the physical therapy you’ll need to regain strength and range of motion in your shoulder. You may need to avoid reaching above your head and picking up heavy objects for a few weeks after surgery as well.
When a shoulder injury requires treatment
Most people will experience a minor injury to their shoulder at some point in their lives. In some cases, these tweaks and strains will resolve on their own with rest, a break from athletic activities, over-the-counter pain medications, and icing.
If you experience sudden pain during activity or after an injury, or you notice symptoms of injury such as swelling, redness, or tenderness around your shoulder that does not resolve after three days, you should make an appointment with your doctor.
If you notice the following symptoms, seek urgent (same-day) care at an urgent care clinic or ER:
- Inability to lift your arm or rotate your shoulder
- Any appearance of deformity
- A popping or grinding sound when you move your arm
- Severe pain
- Sudden increase in swelling
- An injury to your shoulder followed by numbness or other symptoms in your hand or fingers
- Loss of grip strength
In rare cases, shoulder pain can indicate something more serious, like a heart attack. You should always call 911 immediately if you experience shoulder pain accompanied by heart attack symptoms such as:
- shortness of breath
- a racing or fluttering heartbeat
- chest pain or tightness
- pain in your jaw
The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.