Rotator cuff tear

DESCRIPTION AND DEFINITION

  • Rotator cuff tear occurs when tendons pull away from the humerus, usually due to overuse or trauma.

  • Two types: Partial Tear and Complete Tear.

ETIOLOGY OF ROTATOR CUFF TEARS (RCT)

  • Intrinsic factors:

    • Age (most common, degenerative process)

    • Family history

    • Poor posture

    • Prevalence: ~30% in those aged 60+, >60% in those over 80.

  • Extrinsic factors:

    • Overuse, wear and tear from activities (e.g., sports, heavy lifting).

    • Acute injuries from trauma (falls, direct blows).

PATHOPHYSIOLOGY

  • Causes include repetitive overhead motion, aging, and acute trauma.

  • Progresses from inflammation to degeneration leading to partial or full tears.

SIGNS AND SYMPTOMS

  • Limited range of motion

  • Sounds of cracking/popping

  • Shoulder weakness

  • Symptoms include dull ache, sleep disturbances, and difficulty with daily activities (e.g., grooming).

COMPONENTS OF A THOROUGH PATIENT SCREENING

  • Tests Include:

    • Neer's impingement, Belly-press, Hawkins-Kennedy, Lift-off, Infraspinatus, Jobe's test.

  • Assess subjective history, ROM (PROM, AAROM, AROM), strength, specific testing (WORC index), imaging (MRI, X-Ray, Ultrasound).

TRADITIONAL TREATMENT

  • Occupational Therapy (OT): Regaining motion, ergonomics, manage pain.

  • Physical Therapy (PT): Initial assessment, targeted strength exercises.

  • Rehab Exercises: Focus on isometric and wand exercises for shoulder.

SOCIAL IMPLICATIONS

  • Affects ADLs, employment related to overhead work, quality of sleep, mental health, and social interactions.

  • Patients report intense pain, sleep disturbances, and limitations in daily tasks, adversely affecting quality of life.