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The duration of symptoms does not correlate with rotator cuff tear severity or other patient-related features: a cross-sectional study of patients with atraumatic, full-thickness rotator cuff tears The intent of this study was to determine whether the duration of symptoms correlated with more advanced findings of rotator cuff tear severity on magnetic resonance imaging, worse shoulder outcome scores, more pain, decreased range of motion, and less strength. This was not a prospective study, however, it was a cross-sectional study so it does not necessarily inform our understanding of the natural history of this condition. They found that a longer duration of symptoms did not correlate with more severe rotator cuff disease, the amount of weakness weakness, limitations in range of motion, tear size, fatty atrophy, or patient-reported outcome measures. As we've pointed out in prior posts, the amount of pain does not correlate with the magnitude of the cuff tear - complete tears of the ...

Treatment of non-traumatic rotator cuff tears This article was pointed out to us by one of our readers - thanks! It is an extremely well done bit of clinical research. The authors compared three different methods of treating symptomatic non-traumatic tears of the supraspinatus tendon in patients above 55 years of age. Inclusion criteria:   Age > 55 years  Atraumatic symptomatic supraspinatus tendon tear comprising < 75% of the tendon insertion and documented with MRI  Full range of motion of the shoulder  Written informed consent Exclusion criteria   Age < 55 years  History of trauma relating to the onset of symptoms  A massive tendon tear involving the whole supraspinatus tendon and/or combined tear of two to three tendons  Stiffness of the glenohumeral joint (passive external rotation < 30° ± elevation < 120°)  Glenohumeral osteoarthritis with present osteophytes in radiographs  Systemic corticosteroid or antim...

Individuals with rotator cuff tears can do well without surgery. With the exception of an acute traumatic cuff tear that results in an abrupt loss of strength, there is usually an opportunity for non-operative management. This is particularly the case for partial thickness tears on one hand and larger atraumatic tears on the other. Interestingly and importantly a  high percentage of cuff tears are asymptomatic  and need no treatment. We recall that rotator cuff tears may be associated with symptoms of stiffness , weakness, crepitance and instability. We also know that rotator cuff repair requires prolonged protection of the repair so that the individual often cannot return to work or even activities of daily living for months after repair surgery. Therefore, we offer those individuals with non-acute cuff tears a trial of non-operative management emphasizing gentle stretching exercises - especially those directed at achieving a full range of passive motion (see here , especial...

It is important to recognize that many tears of the rotator cuff are asymptomatic , that is the individual with a cuff tear is unaware that there is a problem with the shoulder. Shoulders with rotator cuff tears may have symptoms, including pain, weakness, crepitance (clicking and popping on movement), stiffness or instability. The presence of a rotator cuff can often be identified by a good history and a physical examination.   Some of the tests are reviewed here. The diagnosis can be confirmed by imaging tests,  but the cost of imaging of the rotator cuff can be substantial. Here is more information on cuff tears and their diagnosis See more of the Rotator Cuff Book   here. === Consultation for those who live a distance away from Seattle. **Check out the new Shoulder Arthritis Book -  click here. ** To see the topics covered in this Blog, click  here Use the "Search" box to the right to find other topics of interest to you. You may be interested in some of ou...

The most common type of rotator cuff tear is a failure of the tendon attachment to the tuberosity. The most common location for this tear is at the anterior aspect of the supraspinatus tendon near the biceps tendon. Details on the patterns of rotator cuff failure can be seen here . The usual mechanism of injury of the rotator cuff is when an unexpected load is applied to the arm, such as a fall or a sudden lift with the arm away from the body. These mechanisms are explained in some detail here. A number of factors have been identified that increase the risk of rotator cuff tearing, including advanced age, smoking , anabolic steroids, and steroid (cortisone) injections. While it takes a major force to tear the tendon of a young healthy shoulder, the rotator cuff of a shoulder with the risk factors may fail without any noticeable injury. Thus it is useful to distinguish cuff tear (i.e. a traumatic injury) from cuff wear (i.e. failure without an injury) in that this distinction has major ...