Shoulder Pain Management

Rotator Cuff Tear¹

Presentation and History

Rotator cuff injuries are more commonly seen in adult and senior patients. However, the condition occurs in both young and old patients.

Quick Clinical Points

• Rotator cuff tears are more common in older patients.
• Pain is typically the chief complaint.
• Weakness may be a sign of an incomplete tear.
• Significant loss of shoulder motion may be a sign of a complete tear.

In the younger, more active patient, rotator cuff injury is typically the result of trauma or unusually demanding activity, as in some sports. In adult and senior patients, rotator cuff injury is typically the result of a natural loss of elasticity that makes the rotator cuff more prone to injury even during routine daily activities. This natural tendency toward less elastic muscles may explain the higher incidence of rotator cuff injury among adult and senior patients.

Pain is the most common symptom of a rotator cuff injury. Pain is often felt in the deltoid region of the arm and on the outside of the shoulder. The pain is often made worse by specific shoulder movements and is often described simply as generalized discomfort. Loss of motion may accompany the pain if the rotator cuff tear is more severe. Additional features may include crepitus, catching and stiffness.

Pain will be the primary complaint for patients who have incomplete rotator cuff tears. For incomplete tears, weakness may be a concomitant symptom, but this complaint is generally secondary to pain.

Loss of motion through normal movements of the shoulder will be a prominent feature in complete rotator cuff tears.

Diagnosing a rotator cuff tear requires isolation and testing of the specific muscles that form the rotator cuff during physical examination.

Reference