Rotator cuff tear

We’ll help you return to your everyday life as quickly as possible

Are you finding that normal everyday activities such as brushing your hair, carrying shopping bags or putting on your coat are suddenly difficult to do? This may be due to a rupture of the rotator cuff in your shoulder, or a rotator cuff tear. It’s one of the most common shoulder joint injuries in Germany. And the associated shoulder pain reduces your quality of life significantly.

The consultants and orthopaedic specialists at Schoen Clinic have specialised in treating shoulder disorders and injuries for many years. Through our experience, we’ll help you get your normal life back as quickly as possible. 

Causes & symptoms

What is a rotator cuff tear?

The shoulder joint is the most flexible joint in the body. It’s made up of the humerus head and the joint socket. Compared to other joints such as the knee or hip, the shoulder joint is only loosely secured to the bones: muscles, tendons and ligaments, in conjunction with the joint capsule, are primarily responsible for the crucial task of stabilising the joint.
A special group of four tendons in total ensure that the joint is directed with strength and stability and, most importantly, that it’s centred. This group of tendons is called the rotator cuff because they lie on the humerus head like a cuff. The rotator cuff muscles that run from the shoulder blade to the humerus bone (the subscapularis muscle, the supraspinatus muscle, the infraspinatus muscle and the teres minor muscle) move the arm up and to the side, turn it outwards and inwards and stabilise the arm on the torso.
These tendons run directly around the joint along a narrow bony canal between the humerus head and shoulder cap. Wear and tear can occur over time, especially in the supraspinatus tendon, and this is unnoticeable at first. In extreme cases, a hole or tear in the tendon can occur. This also typically affects the supraspinatus tendon in particular.

Causes: how does a rotator cuff tear occur?

From falls to sports injuries and even heavy lifting, there are many causes behind a rupture of the rotator cuff, also known as a rotator cuff tear. While just around 5% of tendon tears in the shoulder joint occur as a result of an accident in younger patients, rotator cuff ruptures due to degeneration are much more common, making up approximately 95% of cases. In this instance, the tendons have already been damaged due to wear processes and have thereby lost some of their stability. Just a minor fall or forceful ordinary movement is enough to finally injure the already damaged tendons.

Rotator cuff tear: symptoms that are signs of this injury

Many patients with a rotator cuff tear report a dragging or stabbing pain in the shoulder region that can radiate to the neck area or even the hand. This pain is typically even more severe at night, restricting the ability to have a good night’s sleep. Losing tension in these muscles and the ability to automatically maintain posture leads to significantly reduced mobility. In particular, moving the arm forwards or to the side will no longer be possible. This has far-reaching consequences. Those affected are severely limited in their everyday life, so their quality of life is reduced. They can no longer handle everyday activities that seemed normal before, such as brushing their hair or carrying shopping bags, or they can only complete them with great effort.

Diagnostics

Diagnosis: how we determine a rotator cuff rupture

The functions test provides us with the first signs of a tendon tear. In this test, our specialists examine and assess the mobility and strength of your shoulder. In the case of a rotator cuff rupture, you’ll normally no longer be able to move your arm forwards or to the side. In addition, there’s often a loss of strength as well. A lot of those affected report having pain at night after the injury – they are barely able to lie on the arm.

Imaging procedures for examining the shoulder

We can only accurately assess the bony structures using X-ray recordings. But because a rotator cuff tear involves an injury to the muscles and tendons, other imaging procedures are often used during diagnostics. X-ray images are still very important when diagnosing a rotator cuff tear – only X-ray images can be reliably used to determine whether the rotator cuff still directs or centres the humerus head stably in the joint. MRI performed with patients in the supine position cannot provide this information.

Ultrasounds and magnetic resonance imaging show destroyed structures

Using ultrasound examination (sonography) and magnetic resonance imaging (MRI), we can analyse the status of the soft tissue inside your shoulder.
Ultrasounds allow for clear images of the tear in your muscle and tendon apparatus. But changes to the tendons and any effusions inside your shoulder joint are also visible.
MRI examination offers the most accurate view of the affected joint. This presents the joint in high resolution, allowing us to reliably establish which structures are damaged.