Rotator Cuff Tears – Partial, Full Thickness

Rotator cuff tears are a common shoulder injury and can be classified as either partial thickness or full thickness tears.

Partial thickness tears involve damage to the rotator cuff tendon that does not completely penetrate the entire thickness of the tendon. These types of tears can be either articular-sided, involving the surface of the tendon that attaches to the humeral head, or bursal-sided, involving the opposite surface of the tendon. Partial thickness tears can cause pain, weakness, and decreased range of motion, but may not necessarily require surgical intervention. Treatment for partial thickness tears typically includes rest, physical therapy, and anti-inflammatory medication. If conservative treatment fails, surgery may be considered.

Full thickness tears involve a complete tear of the rotator cuff tendon, which can range in severity from a small tear to a complete detachment of the tendon from the bone. Full thickness tears can cause significant pain, weakness, and loss of function in the shoulder. Treatment for full thickness tears typically depends on the size and severity of the tear, as well as the patient’s age and activity level. Smaller tears may be treated with rest, physical therapy, and medication, while larger tears may require surgical repair.

It is important for individuals with rotator cuff tears to seek medical attention and receive an accurate diagnosis and treatment plan from a qualified healthcare provider.

Causes of Rotator Cuff Tears

Rotator cuff tears can be caused by a variety of factors, including:

Trauma: A traumatic injury to the shoulder, such as a fall or a direct blow to the shoulder, can cause a rotator cuff tear.

Overuse: Repetitive overhead motions, such as those performed in certain sports or occupations, can put stress on the rotator cuff tendons and lead to tears over time.

Aging: As we age, the tendons of the rotator cuff can become weakened and more susceptible to tearing.

Poor posture: Poor posture can cause imbalances in the muscles around the shoulder, which can put increased stress on the rotator cuff tendons and lead to tears.

Genetics: Some individuals may have a genetic predisposition to rotator cuff tears.

Other medical conditions: Certain medical conditions, such as diabetes, can weaken the tendons and increase the risk of rotator cuff tears.

Smoking: Smoking has been shown to impair the healing of rotator cuff tears.

It is important to note that rotator cuff tears can result from a combination of these factors, and that some individuals may be more susceptible to tears than others. Proper diagnosis, treatment, and rehabilitation can help to manage the symptoms of a rotator cuff tear and prevent further damage.

Signs and Symptoms Rotator Cuff Tears

The signs and symptoms of rotator cuff tears can vary depending on the severity of the injury. There are two types of rotator cuff tears: partial-thickness and full-thickness tears. Here are some of the common signs and symptoms of each type:

Partial-thickness tears:

• Pain: Pain in the shoulder is the most common symptom of a partial-thickness rotator cuff tear. It may be present at rest, during movement, or with certain positions.
• Weakness: Weakness in the shoulder or arm may be present, particularly when performing activities that require overhead movement.
• Limited range of motion: The range of motion in the shoulder may be limited, particularly when attempting to reach overhead.
• Clicking or popping: You may hear clicking or popping sounds in the shoulder joint with movement.

Full-thickness tears:

• Severe pain: The pain associated with a full-thickness rotator cuff tear is typically more severe than that of a partial-thickness tear.
• Weakness: Weakness in the shoulder or arm is often more pronounced with a full-thickness tear, and may make it difficult to perform even basic tasks.
• Limited range of motion: Range of motion in the shoulder is often significantly limited with a full-thickness tear, and may be accompanied by a feeling of stiffness or tightness.
• Audible cracking or popping: You may hear a snapping, cracking or popping sound in the shoulder when the rotator cuff tears.
• Nighttime pain: Pain may be particularly severe at night, particularly when lying on the affected shoulder.

It’s important to see a healthcare professional if you experience any of these symptoms, as early diagnosis and treatment of rotator cuff tears can help prevent further damage and improve outcomes. Treatment options may include physiotherapy, medication, or in severe cases, surgery.

Treatment for Rotator Cuff Tears

Physiotherapy is often an important part of the treatment plan for rotator cuff tears. The aim of physiotherapy is to manage pain, improve function, and prevent further injury. Treatment will vary depending on the severity of the tear but may include:

Strengthening exercises: Strengthening the muscles around the shoulder joint, particularly the rotator cuff muscles, is an important part of the recovery process. Your physiotherapist will develop a program of exercises that is appropriate for your level of function and the severity of the tear.

Range of motion exercises: Gentle exercises to improve the range of motion in the shoulder can help reduce pain and improve function.

Manual therapy: Manual therapy techniques, such as joint mobilization or soft tissue massage, can help reduce pain and improve mobility in the shoulder joint.

Modalities: Modalities such as heat or cold therapy, ultrasound, and electrical stimulation can help reduce pain and promote healing.

Proprioceptive training: Proprioceptive training involves exercises to improve your shoulder’s proprioception, which can help improve stability and reduce the risk of future injuries.

Taping or bracing: Taping or bracing the shoulder can help provide additional support and stability to the joint, which can help reduce symptoms and prevent further injury.

Your physiotherapist will work with you to develop a customized treatment plan based on your individual needs and goals. It is important to follow your physiotherapy program as directed and to communicate any changes in your symptoms to your healthcare provider. In more severe cases, surgery may be required, and your physiotherapist can help guide you through the post-operative rehabilitation process.

If you have any questions or would like to speak to a therapist about rotator cuff tears please call us at 03 9836 1126.

Reference:

Dong, W., Goost, H., Lin, X. B., Burger, C., Paul, C., Wang, Z. L., & Zhang, T. Y. (2017). Treatments for shoulder impingement syndrome: A PRISMA systematic review and network meta-analysis. Medicine, 96(6), e6047.