full thickness rotator cuff tear

4 min read 12-03-2025

Meta Description: A comprehensive guide to full thickness rotator cuff tears. Learn about causes, symptoms, diagnosis (MRI, X-ray), and treatment options including surgery (arthroscopic repair) and physical therapy. Discover how to manage pain and regain shoulder function. Get expert advice on recovery and prevention.

What is a Full Thickness Rotator Cuff Tear?

The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint. These muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) help lift, rotate, and stabilize the arm. A full thickness rotator cuff tear means one or more of these tendons are completely torn, all the way through. This is different from a partial tear, where only some of the tendon fibers are damaged. A full-thickness tear often requires more extensive treatment.

Causes of a Full Thickness Rotator Cuff Tear

Several factors can contribute to a full-thickness rotator cuff tear. These include:

Age: Tears are more common in people over 40, as tendons naturally weaken with age.
Sudden Injury: A fall, direct blow to the shoulder, or forceful lifting can cause a sudden tear. Athletes, particularly those engaging in overhead activities, are at higher risk.
Repetitive Overhead Activities: Repeated movements, like painting or throwing, can gradually wear down the tendons, leading to a tear.
Degenerative Changes: Age-related wear and tear on the tendons can make them more susceptible to tearing.
Poor Blood Supply: Reduced blood flow to the rotator cuff tendons can impair healing and increase tear risk.

Symptoms of a Full Thickness Rotator Cuff Tear

The symptoms of a full thickness rotator cuff tear can vary depending on the size and location of the tear. Common symptoms include:

Shoulder Pain: Pain may be sudden and severe following an injury, or it may develop gradually. Pain is often worse at night.
Weakness: Difficulty lifting or rotating the arm, particularly away from the body.
Limited Range of Motion: Inability to fully raise or rotate the arm.
Clicking or Popping: A sensation of the shoulder clicking or popping during movement.
Swelling: Swelling or bruising around the shoulder.
Atrophy: Loss of muscle mass in the shoulder may be noticeable over time.

When to See a Doctor

Seek medical attention immediately if you experience severe shoulder pain, especially after a fall or injury. If you experience gradual onset weakness, limited range of motion, or persistent shoulder pain, it's also important to see a doctor for evaluation.

Diagnosing a Full Thickness Rotator Cuff Tear

Diagnosis typically involves a physical examination and imaging tests:

Physical Exam: Your doctor will assess your range of motion, strength, and palpate the shoulder for tenderness. Specific tests can help identify rotator cuff involvement.
X-ray: While X-rays may not directly show the tear, they can rule out other causes of shoulder pain, like fractures or arthritis.
MRI: Magnetic Resonance Imaging (MRI) is the most reliable method for diagnosing rotator cuff tears. It provides detailed images of the tendons and surrounding tissues, allowing for precise identification of the tear's size and location.

Treatment for a Full Thickness Rotator Cuff Tear

Treatment options depend on several factors, including the size and location of the tear, your age, activity level, and overall health.

Non-Surgical Treatment

Non-surgical treatments are often the first approach for smaller tears or for individuals who are not very active. Options include:

Rest and Ice: Resting the shoulder and applying ice can help reduce pain and inflammation.
Pain Medications: Over-the-counter pain relievers like ibuprofen or naproxen, or prescription pain medications may be necessary.
Physical Therapy: Physical therapy plays a crucial role in strengthening the surrounding muscles and improving range of motion. A physical therapist will design a personalized program tailored to your needs.
Corticosteroid Injections: Injections can temporarily reduce pain and inflammation, but they are not a long-term solution.

Surgical Treatment

Surgical repair is often considered for larger tears, significant pain, or if non-surgical treatments have failed to provide adequate relief. Common surgical procedures include:

Arthroscopic Repair: This minimally invasive procedure involves using small incisions and specialized instruments to repair the torn tendon. It often leads to faster recovery and less scarring than open surgery.
Open Repair: This more invasive procedure may be necessary for very large or complex tears.

Recovery from Surgery

Recovery from rotator cuff surgery varies depending on the extent of the tear and the type of surgery performed. It often involves:

Immobilization: The shoulder may be immobilized in a sling for a period of time.
Physical Therapy: A comprehensive rehabilitation program is essential for regaining strength, range of motion, and function.
Gradual Return to Activity: A gradual return to normal activities is important to avoid re-injury.

Preventing Rotator Cuff Tears

While some tears are unavoidable, you can take steps to reduce your risk:

Warm-up before exercise: Properly warm up your shoulder muscles before engaging in physical activity.
Maintain good posture: Good posture can help prevent strain on the shoulder joint.
Strengthen shoulder muscles: Regular exercise to strengthen the rotator cuff muscles can help prevent tears.
Maintain a healthy weight: Excess weight can put extra strain on the shoulder joint.

Conclusion

A full-thickness rotator cuff tear can be a painful and debilitating condition. However, with appropriate diagnosis and treatment, many individuals can regain significant function and reduce pain. Early diagnosis and adherence to a comprehensive treatment plan are key to successful recovery. Remember to consult with your doctor or physical therapist to determine the best course of action for your individual situation. They can guide you through the healing process and help you get back to doing the things you enjoy.