To find out if you have a torn rotator cuff, your doctor will start with a history of the injury and a physical examination of the shoulder. During the exam, he’ll check your range of motion and muscle strength. He’ll also see what movements make your shoulder hurt.
In addition, your doctor may use one of the following:
- MRI. This uses radio waves and a powerful magnet to make detailed pictures of your shoulder.
- X-rays to see if the top of your arm bone (humeral head) is pushing into your rotator cuff space.
- Ultrasound to see the soft tissues (tendons and muscles and the bursas) in your shoulder.
Your doctor is likely to start with a combination of physical therapy to make your shoulder muscles stronger, and medications like acetaminophen and anti-inflammatory drugs to help with pain and swelling. Surgery may be required in some cases.
You also may get exercises to do at home and suggestions that help you use your shoulder in safer, more comfortable ways in your day-to-day life.
If those don’t work, you may need surgery, especially if you have a complete tear. It’s likely your doctor will need to stitch together the torn area or reattach the tendon to the bone.
In some cases, he might need to take out small pieces of tendon or bone that are stuck in your shoulder joint or remove small areas of bone or tissue to give your tendon more room to move.
There are three types of rotator cuff surgery:
- Arthroscopic: Your doctor will make a small cut in your shoulder then use an arthroscope — a tube with a small camera and tiny instruments — to fix the tear. This means your recovery time will likely be shorter than it would with another type of surgery.
- Open: Your doctor uses larger instruments to go in to the muscles of your shoulder and fix the tear.
- Mini-Open: This uses both arthroscopic and open methods. Your doctor starts with the arthroscope and finishes with larger instruments.