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Workplace Injury of the Week: Rotator Cuff Tear

rotatorcufftearIf you know a lot of tennis or baseball players, you probably know someone who’s torn their rotator cuff.

Rotator cuff tears also are common in those who perform overhead work (e.g., warehouse workers, laborers, carpenters, painters, construction workers).

Men are twice as likely as women to sustain them, mostly because more men work in heavy-labor jobs.

The rotator cuff is a group of four muscles that surround the ball-like humeral head of the upper arm. The tendons of these muscles come under stress from repeated activities that require lifting and rotating the arm. Any abnormalities of the shoulder joint can aggravate the stress, especially joint looseness (laxity), rubbing of the front edge of the shoulder blade (acromion) on the rotator cuff (impingement syndrome), bone spurs, and bursitis. As the tendons become irritated, inflammation develops (tendinitis). Circulation to the rotator cuff decreases with age and the tendons themselves degenerate over time. Eventually, this can lead to weakening and even tears in the rotator cuff.

Tears are described as either partial thickness tears or complete rupture, depending on the amount of tissue damage. Partial tears do not go all the way through the cuff, although a large surface area may be involved. Complete tears create a gap in the cuff with concomitant loss of function.

Conservative treatment of small rotator cuff tears (less than 3 cm) of short duration (less than 6 to 12 months) results in a good return to normal functioning for 40% to 90% of individuals (Felsenstein). However, the rehabilitation process may take 6 months or longer and requires an ongoing commitment to a home exercise program to prevent recurrence. Younger individuals are more likely to regain complete function than older individuals. However, athletes are not always able to return to previous levels of competition, especially after a full-thickness rotator cuff tear.

The median return-to-work duration for rotator cuff tear is 72 days.


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