The rotator cuff (RTC) is a group of muscles that surrounds the shoulder joint. It is made of the supraspinatus, infraspinatus, subscapularis, and the teres minor. These muscles work in conjunction so that the shoulder can perform all functions including rotating and lifting. RTC tears are a common injury and almost 2 million people visit their doctors for this issue each year. Tears occur most frequently to the dominant arm. Risk factors of RTC tears are:

1. Being over the age of 60
2. Smoking
3. Having a history of RTC tear
4. Doing repetitive overhead activities, such as in occupations like construction
5. Practicing poor posture
6. Having past trauma

Tears to this group of muscles can occur over time due to degeneration. Microtears can continuously occur to the tendons of the RTC over several years until a person lifts a heavy object and the RTC tears completely. This is mostly seen in older people. Tears can also occur due to traumatic events such as blows to the shoulder or falls on the shoulder. These traumatic events are mostly seen in younger people. There are 2 main types of tears:

1. Partial: This is a tear where the tendon is damaged but not completely separated from the bone. This type of tear responds well to conservative measures like physiotherapy.
2. Full thickness: this is a complete tear where the tendon is completely separated from the bone. These tears are more severe and normally require surgery.

Symptoms of an RTC tear include:

1. Pain at night/ at rest
2. Pain when doing movements like lifting/lowering items, and rotating the upper extremity
3. Weakness
4. Crepitus/ crackling sound or movement in the upper extremities
5. Pain that does not go away when using over the counter medications
6. Pain when carrying heavy objects

Not all RTC tears are painful. Some RTC tears can be asymptomatic whereas others may only be accompanied by a loss of motion or by weakness. Diagnosis of RTC tears usually includes a physical exam and imaging such as x-rays, ultrasound, and MRI/MRA imaging. If a tear is discovered, treatment usually includes surgery and physiotherapy for complete tears; incomplete tears may only require physiotherapy.

If you would like to avoid RTC tears you can follow these 5 secrets to a stronger shoulder:

1. Avoiding repetitive motions – Repetitive motions can damage the shoulder joints. These motions are often seen in sports like baseball, tennis, and rowing. They can also be seen in some jobs like construction and when doing routine chores. It is best to be mindful when doing these activities that require repetitive motions and trying to do them while using the correct form.
2. Improving your posture – Improper posture has been linked to developing RTC tears due to the poor alignment of the shoulder during incorrect posture. Minding your posture can greatly reduce your risks of developing an RTC tear.
3. Improving flexibility- Stretching the muscles that surround the shoulder will make movements, such as overhead and end-range movements, easier. This can decrease your likelihood of developing an RTC tear.
4. Not smoking – Smoking constricts your blood vessels and reduces blood flow. This can be detrimental to those with microtears to the RTC, as the muscles will not get adequate blood flow and nutrition to heal themselves. Thus, once one engages in heavy lifting, it is more likely for a serious tear to occur.
5. Participating in strength training – Strength training strengthens the muscles around the shoulder joints and make them less likely to tear during heavy lifting.

Taking the above 5 secrets into consideration could save you from suffering a RTC tear in your future. Here’s to the health of your shoulder!