Rotator Cuff Tear

June 15, 2014 | Conditions

The Rotator Cuff describes the group of four muscles and tendons surrounding the glenohumeral (shoulder) joint, which keep the bones of the shoulder in place and allow the joint to function properly. These four muscles are:

  • Supraspinatus
  • Infraspinatus
  • Teres Minor
  • Subscapularis




While people who perform repeated overhead motions or exercises are more susceptible to Rotator Cuff injury, anyone may develop the condition over time. In addition, the risk of Rotator Cuff tears increases as we age.


Rotator Cuff injuries typically fall into two categories, traumatic and micro-traumatic:

Traumatic injuries happen fast, usually as the result of a single event. For example, trying to lift too heavy an object, falling and catching your full weight, or experiencing a quick pull at the shoulder joint.
Micro-traumatic Rotator Cuff tears describe repeated stress injury over time. These micro-traumas may happen over a period of weeks, months or even years. Sometimes, Rotator Cuff tears can be the result of a poorly healed traumatic injury that resurfaces after many years as micro-trauma.

Of the two, micro-trauma is the most common. This is because these injuries are caused by straining or pinching the Rotator Cuff tendons repeatedly over time. These strains cause bruising and swelling, which, in addition to making the soft tissue more vulnerable to injury, will decrease the available space between the tendons and the bones forming the shoulder joint. This tighter space leads to additional pressure on the tendons, increasing the risk of micro-trauma.

Symptoms of Rotator Cuff Injury

Rotator Cuff injury is one of the most common causes of shoulder pain. However, it is possible to tear your Rotator Cuff and not feel any pain associated with that injury until much later, if at all. However, the injury – and the pain level – can escalate quickly.

Most people notice a Rotator Cuff injury first as a dull, ache deep inside the shoulder joint. The pain may be increased by reaching above your head or behind your back. The pain may also cause fitful sleep. Other symptoms include:

  • Periodic weakness in the shoulder joint
  • Pain while lying on the affected shoulder
  • Persistent dull ache
  • Occasional sharp pain, especially when reaching or lifting
  • Reduced shoulder function
  • “Clicking” or tightness in the shoulder when elevating the arm

Moderate tears can be very painful, resulting in severe discomfort and difficulty moving your arm. As the injury progresses, many people will begin to feel a constant, dull ache, even while resting. You may also no longer be able to raise your arm or reach above your head or behind your back.

Serious Rotator Cuff injuries are accompanied by severe pain and/or significant weakening of the joint. In some cases, pain transmitters are torn along with the tendons, which will result in less pain but increased weakness.

Diagnosing Rotator Cuff Tear

During your initial visit, Dr. Skaliy will ask you about your personal and family medical history and complete a physical examination to determine the location and extent of the symptoms related to your shoulder issue. During the shoulder examination, Dr. Skaliy will:

  • View your shoulder joint, front and back
  • Check the position of the Scapula (shoulder blade)
  • Look for any unusual muscle atrophy
  • Rotate your shoulder
  • Raise your arm up and down
  • Ask you to complete a few basic arm and shoulder movements

While some Rotator Cuff tears can be diagnosed in a physical examination, tears in other areas must be diagnosed through additional methods, including medical imaging. Dr. Skaliy may choose X-rays, Ultrasound and/or MRI.

While a Rotator Cuff tear will not appear on an X-ray, this test may reveal additional or alternate causes of your pain. Magnetic resonance imaging (MRI) reveals the structure of the shoulder and many potential issues. Ultrasound testing reveals soft tissue, including the muscles and tendons, which allow Dr. Skaliy to assess and compare each shoulder joint.

Rotator Cuff Injury Treatment

Small Rotator Cuff tears are often manageable using conservative treatments such as rest, over-the-counter pain medication or Epidural Steroid Injections. These injections, a combination of anesthetic and anti-inflammatory medications, are often effective in reducing pain short term. For persistently painful or moderate tears, Dr. Skaliy may recommend physiotherapy.

When conservative treatments are not effective, some physicians may recommend surgery to repair the muscle or tendon strains or tears. Rotator Cuff surgery is optimal only when the tear is relatively fresh. Old injuries or micro-traumatic tears do not respond as well to surgical treatment. In addition to the inherent risks of surgery – such as infection, stiffness, blood clots or re-injury – recovery from Rotator Cuff surgery can be long and painful, including up to a year of physical therapy and joint rehabilitation. Even with successful rehabilitation, it may take more than six months for you to regain full range of motion and shoulder function.

Successful Non-Surgical Treatment for Rotator Cuff Tears

Because of the difficulties restoring transitional tissue, many patients and physicians rate post-surgical tendon-to-bone healing as “unsatisfactory.” Fortunately, there are better options for restorative treatment without surgery. Both Platelet Rich Plasma (PRP) Therapy and Stem Cell Therapy have proven effective in treating Rotator Cuff injuries.

Platelet Rich Plasma (PRP) — Concentrated blood platelets, donated by the patient receiving treatment, are used to activate and enhance the body’s own healing ability.

Stem Cell Therapy (SCT) — A minimally-invasive treatment that promotes healing and regeneration in the affected joint. For more than a decade now, physicians have been using Stem Cell Therapy to successfully treat 65 different medical condition, including Osteoarthritis.

Stem Cell Treatment has been shown to offer tremendous benefits for patients with Rotator Cuff tears. Patients report significant reduction in pain and improvement in function, especially long-term.

That continual improvement, over time, is one of the most exciting results of Stem Cell Therapy. Because the stem cells continue to grow, heal and regenerate cells, patients experience ongoing increases in function and decreases in pain, even years after the initial treatment.

Imagine how much better and stronger you could feel, and how much better you could sleep, when your pain continues to decrease and your shoulder continues to function better and better —  all without surgery!

For more information about how Platelet Rich Plasma Therapy or Stem Cell Therapy could help with your Rotator Cuff tear, fill out the form here to schedule an appointment with Dr. Skaliy today.


About the Author

Dr. Michael Skaliy

Throughout his career Dr. Michael Skaliy has felt that medicine is a rapidly changing field and he’s continued to stay up to date to bring the latest cutting edge therapies into his practice. Most recently, he introduced stem cell therapy and minimally invasive same day spine surgery, which is done through a small device the size of a pencil.

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