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When you get a rotator cuff tear, you discover all of a sudden how much you use your shoulder for every little thing. Your shoulder is always in use, from getting your coffee in the morning to throwing a football until one day it stops being used. Whether it’s a dull ache or a quick pop followed by pain, a torn rotator cuff can get in the way of your daily life. What makes it happen, and do you really need surgery to fix it? Let’s jump right in.
How Do Rotator Cuff Tears Happen?
The muscles and tendons in your rotator cuff keep your shoulder joint firm and able to move freely. Sometimes it hurts a lot and makes you less stable after it tears. If the tendon is frayed but still whole, the tear is called incomplete. If it’s full, the tendon is called complete. This is what usually does the damage:
1. Wear and Tear Over Time
Not only do you get more gray hairs as you age, but your rotator cuff also starts to get weaker. If you’re over 40, the things you do every day can cause small tears that get worse over time. It’s like a favorite T-shirt that gets frayed at the seams over time.
2. Repetitive Overuse
Your rotator cuff might be giving you the finger if you’ve been lifting, reaching, or moving your arms high for years on end (hello, painters, carpenters, and athletes!). Small tears can turn into bigger problems if you don’t fix them when they happen.
3. Sudden Injuries
It only takes one wrong move sometimes. You might have fallen hard, tried to lift something too big, or thought you could throw a fastball at 90 mph at the company softball game when you couldn’t. A trauma can tear the tendon right away, which makes it painful and hard to move.
4. Poor Blood Supply
Your rotator cuff doesn’t get as much blood flow as it used to as you get older. This makes it harder for the muscles to heal on their own. This means that over time, even small accidents can get worse.
5. Bone Spurs
Rubs on the rotator cuff muscle can happen because of shoulder impingement, which is often caused by bone spurs. This constant rubbing makes the tendon weaker and can cause it to tear in the end. It’s like rubbing a frayed rope against a sharp rock; it will break at some point.
Do You Really Need Surgery?
Good news: not every rotator cuff tear requires surgery. Many people heal with non-surgical treatments, including:
- Rest and changes to your activities: Stop doing the thing that hurt in the first place. We know this is easier said than done.
- Physical therapy: Building up the muscles around the joint can help keep it stable and allow it to move again.
- Anti-Inflammatory Drugs: NSAIDs, such as ibuprofen, can help with pain and stiffness.
- Cortisone injections: These can help with pain and swelling for a short time, but they won’t last forever.
When Surgery Becomes Necessary
Some rotator cuff tears won’t heal on their own, and that’s when surgery might be on the table. You might need it if:
- The tear is big or comes away from the bone totally.
- You’ve been in therapy and medicines for months, but nothing has helped.
- Your shoulder is very weak, or you have trouble doing everyday things.
- Over time, the pain is getting worse instead of better.
Surgical options vary, from minimally invasive arthroscopic repairs to open surgery for severe cases. In some extreme situations where the shoulder joint is also damaged, shoulder replacement surgery might be necessary to restore function fully.
Conclusion
If you tear your rotator cuff, you don’t always need to go to the surgery room. Rehabilitation and treatments that don’t involve surgery can often help you get stronger and more mobile again. If the pain is getting in the way and your shoulder doesn’t work as well as it used to, surgery may be the best choice. In either case, the best way to get back to work is to listen to your body and see a good orthopedic expert.
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