Rotator cuff tear

Background

• Shoulder pain after acute trauma, chronic injury, or acute extension of chronic impingement
• Tears due to chronic impingement in pts >40yr accounts for majority

1. Injury: 90% chronic arms overhead

Diagnosis

1. result of extreme overuse in young adults (e.g. pitchers) or minor trauma in older adults
2. sudden "pop" while lifting overhead
3. lateral pain
4. worse at night
5. abduct arm pain after 20deg
6. relief of pain w/ lido inject
7. (pain free weakness = full tear)

Physical

1. loss of active BUT NOT passive ROM (due to pain)
2. positive impingement signs
3. weakness with drop arm test

Treatment

1. Acute --> sling, PT, ortho f/u
2. Chronic --> PT, ortho
3. Next: MRI, surgery for younger pts with big tear, rehab
4. PT: arm dangle at side, circle 5-10wt

See Also

• Shoulder (Acute - Trauma)