When the rotator cuff becomes weak, damaged, or frayed, it will no longer function as it should. You may experience shoulder pain when doing weight-bearing activities and achy discomfort when you try to sleep. Over time, the joint will become inflamed and damaged as well.
Rotator cuff tears can lead to symptoms like these, and none of them should be ignored. Here’s when non-surgical treatment might work and when a shoulder arthroplasty can help.
What Is a Rotator Cuff Tear?
The rotator’s cuff is a network of muscles and tendons that surround the shoulder’s ball and socket joint. These tissues work together to keep the joint in place while allowing it to have a full range of motion.
Microtears and rips can occur in these tissues, causing pain and destabilizing the joint.
Rotator cuff tears occur most often in those who perform repetitive over-the-head actions. Think golf, tennis, rowing, and lifting. Rotator cuff tears can also result from atrophy, a breakdown that happens when you don’t use a certain muscle very often.
What Are the 4 Types of Rotator Cuff Tears?
1. Tendonitis
Tendonitis is inflammation caused by microtears in cuff tissue. These tears are usually mild.
If you have been diagnosed with tendonitis, you can often stop the activity causing them for a time. This gives your cuff some time to heal. However, don’t stop moving completely because tendonitis tears can be caused by disuse as well.
If the tendonitis continues despite stopping an aggravating activity, then your orthopedist may recommend a personalized home exercise program to strengthen the tissues where they are weak. This can promote your body’s natural ability to heal micro-injuries and protect the shoulder joint.
2. Tendinosis
Tendinosis is the result of repetitive injuries you never allow for healing properly. For example, you continue to play a sport through the pain. This will continually reopen the tears.
As a result, the tissue becomes more frayed, making you prone to shoulder injury, joint inflammation, and joint degradation. If you have advanced to tendinosis, the doctor will usually recommend outpatient physical therapy in addition to allowing your shoulder to heal.
At this point, you still probably don’t need an arthroscopic rotator cuff repair, which is a minimally invasive procedure. And you probably don’t need a shoulder arthroplasty (shoulder joint resurfacing and replacement), but you are progressing in that direction if left untreated.
3. Partial-thickness or Incomplete tear
If the injury advances to a tear, outpatient physical therapy may be able to help. However, the healing process may take a year or more.
You do run the risk that you will reopen it as it’s healing, or it may become a complete tear. In some cases, your doctor may recommend a rotator cuff repair. A shoulder arthroplasty may also be needed if the joint is damaged and not responding to these early treatment options.
4. Full-thickness Tears
The rotator cuff has now completely pulled away from the bone. It’s no longer supporting and stabilizing the joint. The joint becomes more damaged and inflamed, degrading joint tissue.
A small percentage of people with small to medium full-thickness tears may respond to physical therapy. However, most people will need a rotator cuff repair at this point.
If rotator cuff damage has led to significant joint damage, a shoulder arthroplasty may be the next step toward repairing the shoulder and reducing pain.
When a Shoulder Arthroplasty Can Help
Shoulder arthroplasty is usually a last resort treatment for shoulder joint pain. Joint pain can have many causes, but ignoring shoulder pain in its early stages can always progress to the need for more significant surgeries like a joint arthroplasty. At Huntington Orthopedic Institute, we encourage you not to ignore shoulder pain at any age or any stage.
Our orthopedist can assess your shoulder’s current condition and, when possible, help you avoid surgery. Reach out to us today to schedule an appointment.