Torn Rotator Cuff

Your GP says you have “torn your rotator cuff”: now what?

If your GP has told you that you have a rotator cuff tear, you may be feeling a little lost. What does this mean? What are the implications? How will I recover? In this blog post, we will answer all of these questions and more. We will discuss what rotator cuff tendinopathies and tears are, why they occur, and what the best treatment options are. We hope that this information will help to ease your mind and give you a better understanding of your condition.

What is the rotator cuff and how does it tear?

The rotator cuff is a group of four muscles and tendons that attach the shoulder blade to the upper arm bone. These muscles and tendons work to stabilise the ball of the shoulder into the socket. A tear in the rotator cuff occurs when one or more of these tendons becomes damaged. This damage can be caused by overuse, injury, or degeneration due to age and cause shoulder pain.

What are the symptoms of a rotator cuff tear?

The most common symptom of a rotator cuff tear is shoulder pain. This pain may be worse at night or when you attempt to move your arm in certain ways. You will also feel weakness in your shoulder and arm. If there is no weakness, this is great news and you should see a physio to prevent your pain from progressing to a tear!

What’s the difference between a rotator cuff tear and rotator cuff tendinopathy?

A rotator cuff tear is a specific type of shoulder injury that results in the tearing of one or more shoulder tendons. Rotator cuff tendinopathy is a general term used to describe shoulder pain that is caused by the inflammation of the shoulder tendons. This inflammation can be due to overuse, injury, or degeneration. The long answer short is; a tendinopathy can exist without a tear… a tear has probably been preceded by a tendinopathy. The main thing as a patient that you will notice is a significant loss of strength in your shoulder if there is a tear, while both may give shoulder pain.

Rotator cuff tears are one reason for shoulder pain. What should I do if I have a tear?

What does bad treatment look like?

It would be understandable if you weren’t improving after any of the following treatments:

  • complete rest
  • taking painkillers
  • wearing a sling

What is the best treatment for rotator cuff tears?

Firstly, you need to determine whether the pain you are feeling is actually a tear, or just simply a very sore, grumpy and inflamed tendon. They are so commonly misdiagnosed via ultrasound that this form of imaging is now considered to be unreliable. More reliable are either:

1) Clinical testing performed by a musculoskeletal or sports physiotherapist

2) An MRI scan of the shoulder

The initial phases of treatment for rotator cuff tears involves a combination of ice, rest from painful activities and specific strength exercises. Building up specific strength in and around the shoulder is the most important part of rehabilitation. Surgery is only recommended in cases where the tear is large and normal physiotherapy management has failed.

Physiotherapy is a the most cost effective treatment for rotator cuff tendinopathies and tears. Our team at Fixio Physio Dee Why will work with you to create a customised rehabilitation programme that will help to speed up your recovery. Book an appointment now.


How to look after a shoulder dislocation

I have spent decades studying shoulder dislocations. By having them myself and as a musculoskeletal physio on the Northern Beaches. It’s a good thing too, because shoulder dislocations account for about half of all major joint dislocations in Australia.

Maybe you fell off your bike on your way from Manly to Dee Why on the weekend, or copped a shoulder charge in a friendly game of footy and heard your shoulder POP and give way.

There is something about all our sun, surf and sand mixing with plenty of beach volleyball and other stressful-on-the-shoulder sports that make shoulder injuries a daily occurrence.

Thankfully, with effective early management and a solid dose of expert physiotherapy, most shoulder injuries such as dislocations and fractures can be treated without surgery.

The shoulder is an amazing joint that gives us a huge range of movement. The trade off unfortunately, is that the shoulder joint is a little bit more unstable than your hip joint and more prone to dislocation.

How do I know if I have dislocated my shoulder?

Trust me. You’ll know.

Shoulder dislocations are extremely painful and if it doesn’t pop straight back in, you won’t be able to move your arm at all without turning the pain up to 11/10.

If you have dislocated your shoulder, the humeral head in your shoulder pops totally out of your glenoid socket causing:

  • Pain when you move your shoulder
  • Deformity of your shoulder joint – your shoulder won’t be sitting where it should be (ouch)
  • Loss of normal shoulder motion
  • Shoulder tenderness and weakness
  • Bruising and discolouration around your shoulder
  • Swelling
  • Numbness in the shoulder area, arm or hand

What should I do if I dislocate my shoulder?

Shoulder injuries are serious. Do not try to relocate a dislocated shoulder yourself.

The longer it takes to seek attention the more the muscles spasm and the more difficult it is to put the shoulder back into the joint.

If your shoulder does not reduce (pop back in) by itself very quickly you will need to get to your nearest emergency department immediately. If a reduction is not done properly, damage to the humerus, rotator cuff or other structures within the shoulder joint is possible.

This is going to make your already painful injury worse and prolong your rehab.

Ice your shoulder for the first 48–72 hours after dislocation

Ice is going to be helpful for your pain and swelling and you should continue to place ice packs on your shoulder for 30 minutes max every 3 to 4 hours until the pain and swelling are less noticeable.

If your pain is not controlled or you notice numbness of your arm or part of your hand return to the emergency department ASAP.

Wear a sling

But only for as long as your physio or doctor prescribes. The length of time you are in the sling will differ depending on the extent of your injury and there is more harm than good to be done by sitting in a sling for 6 weeks after a dislocation.

During the first phase of recovery only remove your sling to perform your prescribed exercises or to clean under your armpits. Do not lift your arm up; lean forward and let your arm hang.

How long will the effects of a shoulder dislocation last?

Everyone recovers from injury at a different rate.

Your healing process could be anywhere from 4 to 12 weeks, depending on the extent of your injury. With proper healing and rehabilitation you should regain full movement and strength in your shoulder in well under 6 months.

If you do the rehabilitation exercises that are given to you by your physio.

How rehab is performed depends on the extent of your injury, your age and your likelihood of re-injury based on a number of factors. Return to your activity will be determined by how soon your shoulder recovers, not by how long it has been since your injury occurred.

The goal of rehab is to get you back to your pre dislocation activities as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage.

Luckily for you if you are over 40, the likelihood of re-dislocation is quite low whereas if you are under 20, your likelihood of re-dislocation is very high.

You can usually return safely to your sport or activity when:

  • Your injured shoulder has full range of motion without pain
  • Your injured shoulder has regained normal strength compared to your uninjured shoulder.

If you’ve got questions, or a sore shoulder yourself, musculoskeletal physios are experts in shoulder injuries and rehabilitation, so give us a call on give us a call on (02) 8964 4086 or book an appointment.