Accurate diagnosis of rotator cuff injury and timely treatment is important to ensure that further damage is avoided. Advanced imaging and other diagnostic solutions are available today for correct diagnosis.
Board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler provide treatments for the knee and shoulder to patients in Las Vegas, Nevada, and surrounding communities.
Key Causes
The two primary causes for rotator cuff tear development are injury and degeneration.
Acute Tear
The rotator cuff can tear if a person falls down on an outstretched arm or lifts a heavy object with a jerking motion. This tear can also occur along with other shoulder injuries such as a dislocated shoulder or a fractured collarbone.
Degenerative Tear
Most tears occur due to the wearing down of the tendon that occurs gradually over time. Aging leads to this degeneration, and rotator cuff tears occur more commonly in the dominant arm.
In case the patient has a degenerative tear in one shoulder, there is a higher possibility of developing a rotator cuff tear in the other shoulder as well. This can happen even if the patient does not have any pain in that shoulder.
Contributing Factors
Factors leading to degenerative, or chronic, rotator cuff tears are as follows:
Repetitive Stress
Repetitive motions in the same shoulder can stress the rotator cuff tendons and muscles. For instance, sports in the categories of tennis, rowing, and baseball present a higher risk for sustaining rotator cuff injuries.
Lack of Blood Flow
Aging lessens the blood supply in the rotator cuff tendons. In the absence of adequate blood supply, the natural ability of the body to repair tendon damage is compromised. This can eventually cause a tendon tear.
Bone Spurs
The process of aging also leads to bone overgrowth (bone spurs) development on the underside of the acromion bone. Upon lifting the arm, the spurs rub against the rotator cuff tendon.
This condition is known as shoulder impingement. It will weaken the tendon over time and make it most susceptible to tear development.
Diagnosis
Health History and Physical Exam
The doctor will examine the patient’s shoulder after discussing their symptoms and health history. They will evaluate whether the shoulder is tender in a specific area or if there is a deformity. They will also ask the patient to move their arm in various directions to assess the range of motion of the shoulder. On top of this, the doctor will test the patient’s arm strength.
The doctor will check for other issues with the shoulder joint as well. They may examine the patient’s neck to ensure that the pain is not a result of a “pinched nerve” and to exclude other conditions, such as arthritis.
Imaging Tests
X-Rays
X-rays are usually the initial tests that are performed on the shoulders. However, x-rays do not show the soft tissues of the shoulder such as the rotator cuff. Plain x-rays of a shoulder with rotator cuff pain are typically normal or may indicate a small bone spur.
Magnetic Resonance Imaging (MRI) or Ultrasound
These tests can display soft tissues such as rotator cuff tendons in a clearer manner. An MRI or ultrasound can highlight the rotator cuff tear and its location within the tendon as well as the size of the tear.
An MRI can provide the doctor with a better indication of how “new” or “old” a tear is as it can show the rotator cuff muscle quality.
The injury type determines the prognosis for a rotator cuff injury. Severe cases of rotator cuff tears may require surgical correction to restore shoulder strength.
Board certified orthopedic surgeons at the Thomas & Bigler Knee & Shoulder Institute receive patients from Las Vegas, Nevada, and nearby areas for knee and shoulder treatments.If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.