On a clear, sunny day, enjoying sports like tennis, swimming, or golf can feel invigorating—until a sharp pain shoots through your shoulder as you raise your arm. If lifting your arm between 60 and 120 degrees sharp pain, or if nighttime discomfort prevents you from lying on the affected side, the problem may be more than simple muscle soreness. You could be dealing with a rotator cuff tear.
The rotator cuff is a group of four tendons that envelop the shoulder, enabling you to lift and rotate your arm. Damage to even one of these tendons can restrict movement, particularly at certain angles, or cause significant pain. Unlike adhesive capsulitis (frozen shoulder), which causes stiffness and restricted movement even with assistance, a rotator cuff tear usually produces pain only within a specific range, with freer movement beyond that point.
Diagnosis begins with a physical examination. Tests like the "Empty Can Test," which assesses tendon strength in specific positions, help identify potential tears. If a tear is suspected, imaging studies such as ultrasound or MRI are used to confirm the diagnosis. Ultrasound offers a quick and accessible way to detect a tear, while MRI provides detailed information on its size, shape, retraction, and related muscle atrophy—factors critical in deciding whether surgery is needed.
A common question from patients is, “If my tendon is torn, do I need surgery?” Not every tear requires surgical intervention. The decision depends on factors like the extent of the tear, the patient’s age, activity level, symptom severity, and response to nonsurgical treatments. For instance, partial tears, where only part of the tendon is damaged, may improve with medications, injections, or physical therapy.
However, full-thickness tears, where the tendon is completely severed, rarely heal on their own and may worsen over time, often necessitating surgical consideration. Even a 2-centimeter tear might be treated differently in an active 60-year-old compared to an 80-year-old with minimal physical demands.
The key question is how much the tear affects daily life. A small tear causing severe pain that disrupts routine activities or persists despite six months of conservative treatment may require more definitive intervention. The goal of treatment is to restore shoulder function and enable patients to resume a comfortable, active lifestyle. Rather than defaulting to surgery, a tailored approach based on the patient’s unique condition is essential.
Lim Hye Jung, HEALTH IN NEWS TEAM
press@hinews.co.kr
