The shoulder is a complex joint with many moving parts. These parts are all connected to each other and to the rest of your body through various pathways. When one part becomes injured, it may affect the others causing further damage or even failure of some of these joints altogether. There are several different types of rotator cuff tears which include anterior (front), posterior (back) and lateral (sideways).
Anterior Rotation: The most common type of rotator cuff tear is an anterior rotation injury. An anterior rotator cuff tear occurs when the biceps tendon inserts into the shoulder blade instead of going around it like normal. This causes the arm to rotate forward resulting in pain and weakness in this area. A torn anterior rotator cuff will usually cause loss of strength in both arms, especially if they are overused during activities such as throwing a baseball or doing pushups.
Posterior Rotation: Posterior rotator cuff tears occur when the subscapularis muscle inserts into the shoulder blade instead of going around it like normal. This results in a loss of strength in this area due to lack of range of motion. A torn posterior rotator cuff will often result in weakness and pain in this region as well. If left untreated, a posterior rotator cuff tear can lead to permanent disability.
Lateral Rotation: A shoulder blade can also be torn from the humerus (bone) during a lateral rotation injury. This causes the arm to rotate sideways instead of up and down like normal. A torn rotator cuff is a serious and very painful injury that can cause permanent disability if left untreated. Lateral rotator cuff tears usually occur in combination with other types of tears and will most likely require surgery.
Shoulder Instability: Shoulder instability is a condition in which the shoulder easily pops out of place. If this occurs, the shoulder joint may become inflamed causing pain and swelling along with extreme tenderness in the armpit region. This condition may also cause limited range of motion along with severe loss of strength in this area. Shoulder instability can be caused by several different events including a direct blow to the front or back of the shoulder.
What is a Rotator Cuff Tear?
A rotator cuff tear is an injury that occurs in the shoulder area. The rotator cuff is a group of muscles and tendons that surround the shoulder joint and help give it support. Pain in this area is usually the first indicator that something might be wrong. Other symptoms may include weakness, limited range of motion and a popping or snapping sensation that can sometimes be heard.
A rotator cuff tear often occurs in people who use their arms for their occupation. The most common example of this is a person who plays sports on a regular basis such as American football, baseball or weightlifting. It may also be more likely to occur in people who have had previous shoulder injuries. While tears of the rotator cuff are common, they are preventable with proper training, rest and nutrition.
Rotator Cuff Tear Diagnosis
In order to properly diagnose a rotator cuff tear, your physician will ask you questions about your medical history and give you a physical exam. They will want to know how the injury occurred and what your level of pain is like at this time. In addition, they will perform several tests to see what movements you can and cannot do. They will also want to know if you feel a popping or snapping sensation and in which positions this occurs.
An MRI (magnetic resonance imaging) may be ordered in order to get a better look at your shoulder area. In some cases, an arthroscopic exam of the shoulder joint may be recommended in order to see the extent of the injury.
Rotator Cuff Tear Treatment
In many cases, a rotator cuff tear will heal on its own with proper rest, icing, elevation and over the counter pain medication. It is important to avoid using the shoulder as much as possible in order to give the rotator cuff ample time to heal. It can take several months for the rotator cuff to completely heal and during this time you should not engage in any activities that put a strain on this area.
Sources & references used in this article:
The Self-Assessment Corner for Shoulder Strength: Reliability, Validity, and Correlations With Upper Extremity Physical Performance Tests by P Decleve, J Van Cant, E De Buck… – Journal of Athletic …, 2020 – meridian.allenpress.com
The biomechanics of throwing: simplified and cogent by AE Weber, A Kontaxis, SJ O’Brien… – Sports medicine and …, 2014 – journals.lww.com
Shoulder to shoulder: stabilising instability, re-establishing rhythm, and rescuing the rotators! by BM Pluim, REH van Cingel, WB Kibler – 2010 – bjsm.bmj.com