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Shouldering the Load: Rotator Cuff Tears

Ryan Chen, M.D., Resurgens Orthopaedics
Ryan Chen, M.D., Resurgens Orthopaedics

By: Ryan Chen, M.D., Resurgens Orthopaedics

How common are rotator cuff (RTC) tears? The prevalence of RTC tears increases with age. RTC tears are more common over the age of 40. Over one-fourth of patients over 65 have a RTC tear.

What is the rotator cuff and what does it do? The RTC consists of four tendons that dynamically stabilize the shoulder joint and help you to raise your arm.

I was diagnosed with a RTC tear but never injured my shoulder. How is that possible? Most RTC tears do not result from trauma. Fewer than 10% of tears occur from an acute injury. Most RTC tears result from degeneration of the tendon with age and repetitive overuse.

What are symptoms of a RTC tear? Shoulder pain with overhead activities and/or weakness. Pain can be most severe at night and can interrupt your sleep.

My shoulder hurts. Do I need an MRI? Magnetic resonance imaging (MRI) is the most accurate imaging study to detect a RTC tear. However, not everyone with shoulder pain needs an MRI. An MRI may be ordered after a major shoulder injury or for persistent symptoms after a trial of nonsurgical treatment.

What are some nonsurgical ways to treat my RTC tear? Common treatments include rest, activity modification, anti-inflammatory medication, physical therapy or an injection.

Do RTC tears heal on their own? Most full-thickness RTC tears do not heal on their own. However, pain and symptoms from a RTC tear can improve without actual healing. In fact, there are many people who have a tear but no pain. These are called asymptomatic tears and are very common in the elderly.

If I have a tear in my right shoulder, what are the chances I will develop a tear in the left shoulder? A reasonable chance. Recent research found that a certain percentage of patients with rotator cuff tears on one side had an asymptomatic tear on the opposite side that they never knew about.

When should I consider surgery for my RTC tear? Factors to consider include your severity of symptoms, activity level, age, failure of nonoperative measures, tear size, degree of tendon retraction, and quality of tissue. The decision for surgery should be a collaborative one between you and your surgeon.

What are my surgical options? Historically, open incisions were utilized to repair the RTC. Modern advances and minimally-invasive techniques currently allow arthroscopic repair of the RTC with suture anchors in an outpatient setting.

Dr. Ryan Chen is fellowship-trained in sports medicine and specializes in arthroscopic knee and shoulder surgery at Resurgens Orthopaedics. He was voted a “Top Doc in Sports Medicine” by Lifestyles Magazine for 2011-2013. To schedule an appointment with Dr. Chen, please call (770) 422-3290 or visit www.resurgens.com.

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