For starters, both have similar symptoms like pain, swelling, and stiffness. With a tear, the arm can barely move overhead. Tendinopathy tends to happen over months, even years, of overuse. Tears, however, are sharp pains that generally occur after a sports collision or accident.
Symptoms of a rotator cuff tendon tear
Pain in your shoulder, which may be worse with overhead movements or at night from lying on the affected side. Weakness in your arm and shoulder. Trouble lifting up your arm or rotating it. Clicking or crackling sounds when moving or using your arm and shoulder.
A rotator cuff strain is a stretching or micro-tearing of the tendons and muscles surrounding the shoulder joint while a tear is a complete or partial tearing of one or more of the tendons in the shoulder.
Typically tears occur in those over age 40, but occasionally tears are seen in younger individuals. Typical signs of a rotator cuff tear include pain with overhead use of the arm, weakness or pain preventing or disrupting sleep.
Your doctor uses imaging tests to help diagnose a rotator cuff injury. An X-ray helps to rule out bone spurs or osteoarthritis as a cause of your symptoms. An MRI scan enables your doctor to see the soft tissue in the shoulder and determine if you have a rotator cuff tear and whether it is partial or full thickness.
The drop arm test is used to assess for full thickness rotator cuff tears, particularly of the supraspinatus. This can be useful when diagnosing sub-acromial pain syndrome (shoulder impingment) or to differentiate between shoulder and rotator cuff pathologies.
Red flags include: Trauma, pain and weakness, or sudden loss of ability to actively raise the arm (with or without trauma): suspect acute rotator cuff tear. Any shoulder mass or swelling: suspect malignancy. Red skin, painful joint, fever, or the person is systemically unwell: suspect septic arthritis.
Ultrasound does have the ability to identify rotator cuff tendon tears but with certain limitations. One factor is that it requires special training for the staff, as this is a less commonly performed imaging test. Second, the tendons may not be adequately seen in obese patients or those with a limited range of motion.
Rotator cuff tendon tears often cause pain at night. The pain may even wake you. During the day, the pain is more tolerable, and usually only hurts with certain movements, such as overhead or reaching toward the back. Over time, the symptoms become much worse and are not relieved by medicines, rest, or exercise.
A rotator cuff tear may result from an acute injury, such as a fall, or may be caused by normal aging-related wear and tear with degeneration of the tendon. Typically, you will feel pain in the front of your shoulder that radiates down the side of your arm.
A complete tear can make it almost impossible to move your arm. Without treatment, you may have chronic shoulder pain and find it very difficult to use the injured arm.
Probably people can resume their activities like playing sports after six months. However, a complete recovery from a rotator cuff tear might take up to a year in some cases. There is no need to reconnect a partially torn tissue to the bone to regain its full range of motion.
Patients are often advised to wear a sling or brace for the first 4–6 weeks after rotator cuff repair surgery to prevent them from performing any physical activities involving the affected shoulder (3).
It is very uncommon to operate on a partial rotator cuff tear. In cases of deep partial tears — when more than 90 percent of the tendon is torn — surgery is recommended only if the symptoms can't be controlled with nonsurgical treatments.
Can a rotator cuff injury cause pain in your arm and hand, too? Yes. Typically, the pain starts as a dull aching pain in your shoulder. As the injury progresses, it can cause radiating pain down the arm and into your hands.
A rotator cuff injury can cause a dull ache in the shoulder that worsens at night. Rotator cuff injuries are common and increase with age. These injuries may occur earlier in people who have jobs that require repeatedly performing overhead motions, such as painters and carpenters.
In most cases, a rotator cuff tear will not heal on its own. If your pain and other symptoms persist despite conservative treatment such as steroid injections and physical therapy, it's time to speak with a shoulder specialist. Surgical repair is often necessary to restore shoulder function and relieve pain.
Diagnosis of rotator cuff injuries
Sometimes your GP or physiotherapist may need to refer you to a specialist doctor. A specialist might recommend taking images of your shoulder to get a better look at the damage, and plan your treatment. Imaging tests they may recommend include: a shoulder X-ray.
Diagnostic imaging is considered to be the gold standard for rotator cuff injuries, particularly MRI, but it has also proven to be highly expensive. The incidence and prevalence of rotator cuff tears increase with age.
Shoulder Drop Arm Test
You passively elevate the arm and see if they can hold that position without the arm dropping, or shrugging. If the arm drops or shrugs, then the rotator cuff likely isn't able to counterbalance the superior line of pull of the deltoid.
X-rays. Although a rotator cuff tear won't show up on an X-ray, this test can visualize bone spurs or other potential causes for your pain — such as arthritis. Ultrasound. This type of test uses sound waves to produce images of structures within your body, particularly soft tissues such as muscles and tendons.
Your doctor may offer surgery as an option for a torn rotator cuff if your pain does not improve with nonsurgical methods. Continued pain is the main indication for surgery. If you are very active and use your arms for overhead work or sports, your doctor may also suggest surgery.
If a torn rotator cuff isn't treated at all, then there is a good chance that it will get worse as time passes. Worsening symptoms of a torn rotator cuff include: Increased and constant pain. Insomnia due to the pain.
Patients with “well-balanced” massive rotator cuff tears may still have good active motion and be able to perform their activities of daily living.