Is it a rotator cuff tear or something else?
It happens to everyone at some point. You’re working out, gardening, or even just reaching for something in the back seat when suddenly, you have a throbbing pain in your shoulder and trouble moving your arm around.
In fact, shoulder pain affects 67% of the population at some point in their lives. When this pain arises, many people believe they have a rotator cuff tear, as this is by far the most famous shoulder injury. However, the shoulder is a complicated structure, made up of multiple tendons, muscles, and ligaments, meaning that there are actually a number of injuries that can be the cause of shoulder pain.
Let’s take a look and find out if you actually have a rotator cuff tear or if it’s something else entirely.
Shoulder anatomy
In order to understand the different shoulder injuries, we must first understand the shoulder. Generally, there are three parts of the shoulder that are commonly injured.
First, we have the rotator cuff. This is a group of four muscles and their tendons that stabilize the shoulder joint and allow the arm to rotate and make lifting movements.
Next, there is the biceps tendon, which anchors the biceps muscle to bones in the shoulder and elbow. This tendon is what allows us to rotate our forearm and enables arm flexion.
Finally, there is the labrum. The labrum is a ring of rubbery fibrocartilage that lines the edge of the shoulder joint. It deepens the socket and stabilizes the joint. Additionally, it serves as an attachment point for ligaments and the biceps tendon.
Profile of a rotator cuff tear
A rotator cuff tear is when one of the tendons that makes up the rotator cuff becomes frayed, damaged, or completely detached from the bone. There are a number of factors that can confirm your shoulder pain is caused by a rotator cuff tear.
First, pain will be localized to the lateral shoulder, which is the outside of the upper arm in layman’s terms. Next, in many cases, the pain will only occur when laying on the injured side. Additionally, your arm will feel extremely weak, making it almost impossible to lift above your head. Finally, rotator cuff tears are mostly caused by overuse or degeneration due to age, meaning symptoms don’t begin after a specific injury. If all of this describes your shoulder pain, it is very possible that you have a rotator cuff tear.
The great imposters
So, if it isn’t a rotator cuff tear, what could it be? Well, there are three main imposters that are often the culprit. Let’s take a look and see if we can narrow down what’s causing your shoulder pain.
Biceps Tendon Tear
A biceps tendon tear is when one of the tendons connecting the shoulder to the elbow partially or fully tears. It often occurs during a heavy pulling motion. You can tell it is not a rotator cuff tear because pain will be in the front of the shoulder. Additionally, there will often be a popping sensation at the time of injury, followed by a bulge forming lower in the arm. This is a serious injury and biceps tendon tear treatment should begin as soon as possible in order to prevent long term damage.
Shoulder Impingement
Shoulder impingement is when the tendons or bursa in the shoulder are compressed, rubbed, or pinched by surrounding bones. This causes a painful, sharp, or catching sensation in the shoulder when moving the arm. Shoulder impingement can be identified by the “painful arc”. Pain will be at the highest when your arm is halfway up, but lessens as your arm gets up above your head.
Labral Tears
A labral tear is when the labrum is injured or ruptured. This can be painful and make arm movement difficult. The primary identifiers of a labral tear are the mechanical symptoms, such as clicking, grinding, locking, or popping sensations in the shoulder joint. These sensations will usually occur when making overhead, behind-the-back, or throwing movements.
When to see a specialist
Benign shoulder pain should go away within a few days with the use of NSAIDs, rest, and icing the area. If symptoms do not dissipate in this time frame, you should see a shoulder specialist as soon as possible. They will be able to diagnose which shoulder condition you are suffering from and provide a treatment plan. If you wait too long before seeing a specialist, permanent damage may be done.
