Is your shoulder pain a torn rotator cuff?
How to guide for evaluating if your shoulder pain is a torn rotator cuff or a rotator cuff strain prior to seekign medical advice.
1. Assess the Onset of Pain
Rotator Cuff Tear: The pain may have a sudden onset if it's due to an injury, or it could gradually increase over time due to wear and tear. Patients might recall a specific event that triggered the pain, such as lifting a heavy object or a sudden arm movement.
Rotator Cuff Strain: Typically associated with a specific event or overuse, the onset of pain is usually less severe and more localized. The pain might worsen with activity but improves with rest.
2. Evaluate the Type and Location of Pain
Tear: Pain from a rotator cuff tear is often described as a deep, aching soreness within the shoulder, potentially radiating down the arm. It can be severe and constant, especially at night, interfering with sleep.
Strain: Pain from a strain is usually less intense, described as a sharp pain or discomfort when moving the shoulder in specific ways or during certain activities.
3. Notice the Range of Motion and Strength
Tear: A rotator cuff tear may cause significant weakness and limit your ability to lift your arm or perform tasks that require arm movement above shoulder level. There might be a noticeable decrease in the range of motion.
Strain: While a strain can also reduce strength and range of motion, the effects are generally milder. Patients may still be able to perform most activities with some discomfort.
4. Perform Simple Tests
Painful Arc Test: Slowly lift the arm to the side, parallel to the floor, and then continue lifting over your head. Pain between 60° and 120° of this motion could suggest impingement, which is often associated with both strains and tears but can indicate the severity based on pain intensity.
Drop Arm Test: Lift your arm to the side or front to shoulder level, then slowly lower it. Difficulty controlling the arm's descent or experiencing significant pain could indicate a tear.
Strength Testing: Try pressing the palm of your hand against a wall or door frame and pushing, first with the arm at your side and then with the arm raised to shoulder height. Significant weakness or pain during these activities, especially compared to the unaffected side, may suggest a tear.
When to Seek Professional Help
It's important for patients to understand that while these self-assessment methods can provide insights, they are not definitive. Variations in pain tolerance, injury severity, and the presence of other shoulder pathologies can influence symptoms and test outcomes. If shoulder pain:
Persists for more than a few days
Is severe and limits daily activities
Involves significant weakness or inability to use the arm
Occurs alongside symptoms like fever, redness, or warmth (which could indicate infection)
Patients are strongly advised to seek a professional evaluation. A healthcare provider, especially a physical therapist or an orthopedic specialist, can offer a more accurate diagnosis through clinical assessment and imaging studies like MRI or ultrasound. They can also recommend the most effective treatment plan, whether it involves rest, physical therapy, medication, or in some cases, surgery.
