The humerus is the bone that makes up the upper arm. At the top it forms one part of the shoulder joint. Holding the humerus in place are four different muscles as well as a network of tendons. The muscles and tendons are responsible for holding the head of the humerus in the shoulder joint and allowing the shoulder to rotate freely. The term for this network of muscles and tendons is the rotator cuff.
A rotator cuff tear is a relatively common injury for many adults. One muscle, the supraspinatus, is most commonly involved in a rotator cuff tear, but any of the four can be the culprit. The other three muscles are the teres minor, the subscapularis and the infraspinatus. All four of the muscles that make up the rotator cuff are attached to the back by one tendon.
There are two basic ways that most people suffer from a rotator cuff tear. The first is through a single injury. The patient may feel pain and problems with their range of motion over a period of weeks or months before the problem is diagnosed. Once diagnosed, the patient can often recall an incident that led to the tear. The injury can also occur in conjunction with a fracture or dislocated shoulder.
The second way that a rotator cuff tear can occur is by repetitive stress. The overuse of the muscles and tendons that make up the rotator cuff can eventually lead to a tear, particularly in people that engage in sports that emphasize overhead motion, such as tennis or weightlifting. It is not necessary, however, for someone to be engaged in sports to suffer from a rotator cuff tear.
The fact that many rotator cuff tears occur without a particular moment of injury or trauma make them difficult to diagnose. Common symptoms of a rotator cuff tear are pain when lifting or lowering the arm from above the head and weakness when lifting or rotating the arm. For a definitive diagnosis, most doctors will use x-rays or other imaging technology, such as an MRI or ultrasound.
Rotator cuff tears are treated either surgically or nonsurgically. Nonsurgical techniques include rest, anti-inflammatory medication, steroid injections and physical therapy. Surgical treatment involves either trimming the affected area or stitching it together. If the tendon is separated from the bone, it can be reattached surgically.
