Ask the Expert
Dr. William Paterson
Question: I think I have a rotator cuff tear, what should I do?
Answer: The rotator cuff is group of four muscles which attach around the “ball” part of the “ball and socket” shoulder joint. It is a very common cause of shoulder and arm pain, especially in people who are 55-60 years old or more. The problem could be anything from a mild strain of the tendon, up to a complete rotator cuff tear. Typically, a rotator cuff strain is the result of overuse, and will tend to get better after about a week or so of rest, ice and over-the-counter pain medications. If the pain persists beyond a week or two or is severe, it should be evaluated by a physician.
Many factors determine how rotator cuff injuries are treated. We tend to create a plan centered around each person’s individual goals. Fortunately, a strain rarely requires surgery, and usually improves with physical therapy, medicine for pain and occasionally a cortisone injection. If the damage is more significant, as is the case when the tendon is completely torn off of the bone where it normally attaches, surgery may be required to repair the torn tendon. Occasionally, if the damage is severe or if the condition has been present for a very long time, surgical repair of the tendon may not be possible. In these cases, a shoulder replacement may be necessary if the other options (physical therapy, cortisone injections) do not help. For this reason, it is important to have your shoulder evaluated rather than simply ignoring the pain, as the results of early treatment are usually better and less invasive than if the problem has been going on for many months or years.