The rupture is manifested by a painful restriction of movement in the shoulder joint and by the classic signs of inflammation (heat, swelling, redness, pain, restricted function), which may be more or less pronounced. Depending on the extent of the injury, the therapy is conservative or surgical. A rehabilitative physiotherapeutic follow-up treatment is recommended.
Rotator cuff rupture is a common disease in athletes. Throwing movements or falls can cause the rotator cuff to rupture. This includes 4 muscles: These muscles have attachment tendons which run closely past the shoulder joint area.
These tendons can tear in the event of overloading or trauma. In older patients, chronic overloading can lead to degeneration of the tendon, so that it can tear even in the event of minor trauma, or even without any apparent reason.
- M.
Subscapularis
- M. Supraspinatus
- M. infraspinatus and
- M. Teres Minor
Causes
- Rotator cuff ruptures are often caused by accidents in young patients. The tendon can tear if the patient falls onto the arm or if a sudden strong force is developed (e.g. during weight training).
- In older patients, the tendon can also tear as a result of minor trauma or even without any apparent reason. Chronic overloading changes the structure of the tendon and makes it less resilient.
Stressful activities are sports such as badminton or tennis, handball, basketball, but also competitive swimming and many more.
- Professionals working overhead have an increased risk of tearing the rotator cuff. Taking certain drugs, such as cortisone, can also affect the quality of the tendon.
- However, a biceps tendon rupture can also be preceded by a SLAP lesion. In this regard, the article SLAP Lesion Exercises may also be of interest to you.
Symptoms
The rotator cuff rupture manifests itself through various symptoms, some of which can be very unspecific. Others, however, are very typical of rotator cuff rupture. Usually, there is pain in the shoulder, which gets worse especially during movement, should it be possible.
After an acute injury or irritation, the shoulder may be swollen, heated and reddened. The points where the tendons attach to the humeral head are sensitive to pressure. Typical for the tear of the rotator cuff (M. Supraspinatus) is the reduced ability to spread the arm to the side.
With underneath, movement is not possible at all. Sometimes a so-called painful arc occurs between 60-120°. In general, there is a reduction in strength in the shoulder and possibly a feeling of instability.
This painful arc is also found in the so-called impingement syndrome. You can find out what you can do about it in our articles Shoulder Impingement Syndrome – Physiotherapy and Shoulder Impingement – Exercises. In older people, in whom the tendon has appeared without a recognizable reason, the symptoms can appear less intense, become more intense through movement and can become chronic.
Often the tear is not diagnosed until a few months after its occurrence, as the symptoms slowly worsen. Pain in the shoulder is a classic symptom of rotator cuff tearing. However, it can occur very differently in different patients.
Elderly patients often do not even notice the tear in the tendon, as it tears with no apparent reason. These patients often suffer from concomitant shoulder arthrosis, which requires a more detailed investigation of the cause of the pain. There is diffuse pain in the shoulder joint, which increases over time and becomes stronger and more intense, especially during movement or stress.
After a fall or trauma, the pain usually subsides immediately. The acromion and the points where the tendons attach to the humeral head are painful under pressure. The movement of the shoulder joint is often severely restricted due to pain. Pain in the shoulder–neck area can occur after an acute accident as well as in chronic ruptures. By adopting a relieving posture or evasive mechanisms, the shoulder girdle is often strained and severe tensions occur, which can manifest themselves as neck pain as well as headaches.
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