Shoulder Muscle Tears: Symptoms, Causes, Diagnosis, and Treatment

Shoulder muscle tears are among the important causes of pain, loss of strength, and limitation of movement, especially when raising the arm. This condition, commonly referred to as a “shoulder muscle tear,” mostly describes tears in the muscle-tendon group called the rotator cuff, which surrounds the shoulder joint.

What Is a Shoulder Muscle Tear? What Is the Rotator Cuff?

A shoulder muscle tear usually refers to partial or complete tears that occur in the tendons of the rotator cuff muscles surrounding the shoulder joint.

The rotator cuff is a structure made up of four muscles and their tendons that provide shoulder joint movement and contribute to joint stability, extending from the shoulder blade to the head of the upper arm bone, called the humerus. These muscles are:

• Supraspinatus: A significant portion of tears is seen in the supraspinatus tendon.
• Infraspinatus
• Teres minor
• Subscapularis

Damage to one or more of these tendons may cause pain and loss of strength when raising or rotating the arm and during daily activities.

Rotator cuff tears may develop as traumatic injuries due to sudden trauma, or they may occur degeneratively as a result of tendon wear over the years.

What Causes a Shoulder Muscle Tear?

Shoulder muscle tears may generally occur through two main mechanisms: acute injuries and degenerative changes that develop over time.

Traumatic Shoulder Muscle Tears

Falling, suddenly lifting a heavy object, straining the shoulder during sports, or receiving a direct blow to the shoulder area may cause tearing in the rotator cuff tendons.

Especially if sudden pain and significant loss of strength occur after trauma in a previously healthy shoulder, evaluation should not be delayed.

Degenerative Shoulder Muscle Tears

Rotator cuff tendons may undergo structural changes with age. Repetitive shoulder movements and the mechanical loads to which the tendon is exposed over many years may also contribute to this process.

For this reason, rotator cuff tears are more common at older ages. Studies show that the frequency of rotator cuff abnormalities increases significantly with age.

Who Is More Likely to Have a Shoulder Muscle Tear?

Factors that may increase the likelihood of developing a rotator cuff tear include advanced age, repetitive overhead arm movements, heavy physical work, and previous shoulder trauma.

Especially in;

• People working in occupations that require constant overhead work, such as painting and ceiling work,
• People who do sports involving repetitive shoulder movements, such as tennis, swimming, basketball, volleyball, and similar sports,
• People who lift heavy loads or have previously experienced shoulder trauma, rotator cuff problems may be seen.

There are also studies showing that some factors, such as smoking and diabetes, may be associated with tendon health and healing capacity.

What Are the Symptoms of a Shoulder Muscle Tear?

The symptoms of a shoulder muscle tear may vary depending on the size of the tear, which tendon is affected, whether the tear is acute or chronic, and the person’s daily activities.

• Shoulder pain
• Pain when raising the arm upward
• Difficulty opening the arm sideways
• Weakness in the shoulder and arm
• Shoulder pain that increases at night
• Difficulty lying on the painful shoulder
• Difficulty with daily movements such as combing hair or getting dressed
• Pain or limited movement when reaching the hand behind the back
• Loss of strength in shoulder movements

What Are the Types of Shoulder Muscle Tears?

Rotator cuff tears can basically be classified as partial tears and full-thickness tears.

Partial Tear

This is a condition in which part of the tendon is damaged, but the integrity of the tendon is not completely lost.

Full-Thickness Tear

This is a condition in which the tear involves the full thickness of the tendon. In some full-thickness tears, the tendon may completely detach from the area where it attaches to the bone.

The size of the tear, the affected tendon, the amount of tendon retraction, and changes that develop in muscle tissue over time may be important in treatment planning.

How Is a Shoulder Muscle Tear Recognized?

Shoulder pain alone does not mean that there is a rotator cuff tear.

Shoulder pain may also be caused by different conditions such as:

• tendon problems,
• bursitis,
• frozen shoulder,
• arthritis,
• joint problems,
• neck-related problems.

How Is a Shoulder Muscle Tear Diagnosed?

Diagnosis usually begins with a detailed patient history and physical examination. During examination, shoulder range of motion, whether pain occurs during specific movements, and muscle strength may be evaluated. Imaging methods may be used when necessary.

• X-ray: Rotator cuff tendons are not directly visible on X-ray. However, it may be used to evaluate bone changes, arthritis, calcific tendinitis, or bone spurs that may cause shoulder pain.
• Ultrasonography: It allows evaluation of soft tissues. It may also allow dynamic examination of the tendons while the shoulder is moved.
• Magnetic Resonance Imaging (MRI): It helps evaluate muscles, tendons, and other soft tissues around the shoulder in detail. It may provide detailed information about the location and size of the tear and the condition of the tendon.

How Is a Shoulder Muscle Tear Treated?

Treatment of a shoulder muscle tear is not the same for every patient. Treatment is generally divided into two groups: non-surgical treatments (PRP, Stem Cell) and surgical treatment. When creating a treatment plan, the following are evaluated together:

• The patient’s age,
• Daily life and activity level,
• Duration and severity of pain,
• Degree of strength loss,
• Whether the tear is traumatic or degenerative,
• Whether the tear is partial or full-thickness,
• Size of the tear,
• Affected tendon or tendons,
• Response to previously applied treatments.

Physical Therapy for Shoulder Muscle Tears

Physical therapy and rehabilitation have an important place in the treatment of rotator cuff injuries.

Although the content of the program varies according to the patient’s condition, the main goals may include:

• Reducing pain,
• Maintaining or improving shoulder range of motion,
• Strengthening the rotator cuff and muscles around the shoulder,
• Improving shoulder blade control,
• Supporting return to daily activities.

Is It Possible to Prevent Shoulder Muscle Tears?

It is not possible to prevent all rotator cuff tears. Age-related tendon changes, in particular, may not be completely prevented.

However, some measures may help protect shoulder health:

• Using proper technique during repetitive overhead movements
• Avoiding sudden and uncontrolled heavy lifting
• Warming up properly before sports
• Maintaining strength in the muscles around the shoulder and shoulder blade
• Not ignoring recurrent shoulder pain
• Increasing exercise load gradually

When Should a Doctor Be Consulted?

If shoulder pain continues for a long time, disrupts sleep at night, or limits daily life, evaluation may be appropriate.

Especially if severe shoulder pain begins after a fall or another trauma and is accompanied by inability to raise the arm or sudden loss of strength, a healthcare facility should be consulted without delay.

Frequently Asked Questions

References

1. Shoulder Muscle Tears
2. Shoulder Exercises
3. PubMed