Acute Complete Rotator Cuff Tears: Wait It Out Or See A Doctor?

 There is a misconception about the treatment of acute shoulder injuries.  If not treated appropriately, these acute shoulder injuries can lead to poor outcomes and severe disability.

The rotator cuff is a group of 4 muscles in the shoulder that provide stability for the shoulder joint and provide the ability to do work over your head.  The Rotator Cuff also initiates your ability to raise your arm from your side and above your head.  The Rotator Cuff can be damaged from long term wear and tear or from a fall or trauma.  The traumatic tears need to be addressed immediately.  Failure to have these injuries addressed will lead to poor long-term outcome. 

If you have a fall, and you suddenly cannot raise your arm over shoulder height, please get evaluated.  If you are above the age of 30-40, and you have a dislocation (your shoulder “pops” out of the socket), please get evaluated.  You may have a shoulder contusion or bruise that can resolve in 5-7 days, but more than likely you will have an acute full thickness rotator cuff tear.   When the rotator cuff tendon tears away for the humerus, the contraction of the muscle pulls it away from its attachment point.  This will not heal.  The retraction of the tendon leads to scar tissue and muscle atrophy. If not addressed, this becomes a NONREPAIRABLE problem.

I would encourage you to be seen by your sports/shoulder orthopedist.  Do not have a steroid injection.  Do not give the injury 3 months to resolve.  The evaluation will require a history of the injury, x-rays to look for fractures of the bone, and an MRI.  If the MRI shows a new complete rotator tear, then you will need arthroscopic surgery. This is an outpatient procedure that takes 60-90 minutes.  You have approximately 6-8 weeks to have this injury addressed to not affect the long term outcome.  The recovery from arthroscopic rotator cuff repair can take 4-6 months with extensive rehab.  I see patients every week that have waited too long. 

Arthroscopic picture of an Acute Rotator Cuff Repair - Before & After

  If you have an injury, and you have sudden loss of shoulder function, please get evaluated. Time is crucial.