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Torn tendon on the shoulder

Surgery avoidance through conservative combination therapy

If the arm can no longer be moved sideways and severe pain radiates from the shoulder joint, this may be due to a torn tendon in the shoulder. The so-called rotator cuff rupture often occurs as a wear-related phenomenon when anatomical norm variants of the acromion load over a long period of time. Overexertion of the shoulder due to excessive overhead movements and activities away from the body can also cause an impairment that leads to a tendon tear in the shoulder.

A detailed examination with imaging techniques is used to specifically diagnose the tendon injury, which is one of the most common injuries caused by wear and tear. In this context, not only the affected tendon and muscle combination plays an important role for the course of therapy, but also the distinction between partial rupture and complete rupture. Learn about the therapies that help with rotator cuff tears and how conservative therapy offers good options, especially for older patients, in our article on tendon rupture in the shoulder.

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Table of Contents:

Shoulder Tendon Rupture: What is rotator cuff tears?

Structure of the rotator cuff
Difference between partial rupture or complete rupture

Causes of tendon rupture of the shoulder

Signs of wear and tear due to age
Sports injuries and accidents

Symptoms of shoulder tendon rupture

Diagnostics & Therapy of Rotator Cuff Rupture
Treatment for tendon rupture of the shoulder at the Orthopaedic Center Munich East (OZMO)

Shoulder Tendon Rupture: What is rotator cuff tears?

Tendon rupture at the shoulder is called rotator cuff rupture. This is an injury to the tendons that shape the rotator cuff along with the muscles. Four muscle-tendon combinations enable the shoulder to move in almost any direction when healthy. They provide stability and mobility of the shoulder. The rotator cuff is where the joint is found under the acromion.

Structure of the rotator cuff

The rotator cuff becomes the basis for the mobility and stability of the shoulder through four muscles and tendons.

Musculus supraspinatus
Infraspinatus muscle
Subcapularis muscle
Musclus teres minor

Each muscle is supported by the associated tendon in its ability to move as well as return to the base position. The spuraspinatus muscle enables the shoulder to splay. External rotation is made possible by the infraspinatus muscle together with the teres minor muscle. Internal rotation is dependent on the function of the subcapularis muscle and its associated tendon.

Difference between partial rupture or complete rupture

The degree of damage is an important aspect for the physician to initiate the appropriate treatments. In this context, partial rupture refers to a tendon tear, i.e. damage in which the tendon is not completely torn off, in contrast to a true rupture. In the case of a shoulder tendon rupture as a partial rupture, treatment usually provides for pain relief first and foremost, but also for the appropriate form of therapy, for example early functional physiotherapy. In the case of a complete rupture, on the other hand, the focus must be on the best possible promotion of the healing process with the involvement of the reconstruction of the tendon structure. Modern medicine does not always make surgery necessary, even in the case of complete rupture. Instead, conservative combination therapy offers options that benefit older patients in particular. Only in the last step, surgical treatment for tendon rupture in the shoulder is chosen if alternative options cannot achieve good treatment results.

Causes of tendon rupture of the shoulder

The causes of a rotator cuff rupture can be primarily divided into two variants: age-related wear and tear and injuries caused by accidents or overuse during sports.

Signs of wear and tear due to age

In older people, the production of hyaluronic acid decreases, causing tendons to lose elasticity and tone. In addition, there is often reduced blood circulation, which does not ensure optimal supply to the tendons and muscles. In addition, the greater the physical strain was in younger years (for example, working overhead or in a posture distant from the body at work), the greater the signs of wear and tear that stress the tendons in old age. Thus, even mild bruises and impacts can cause small tears in the rotator cuff tendons.

Sports injuries and accidents

Young people are mostly affected by tendon ruptures of the shoulder only when there is a serious physical impact, for example, trauma in the context of an accident such as a fall in which the person is caught with the arm and it is jerked off. Sports can also cause injuries such as dislocations, which overstress the tendons and result in a partial tear or complete rupture of the tendon.

Symptoms of shoulder tendon rupture

In the case of a partial rupture, complaints classically begin insidiously when the arm is moved sideways or, in the case of a partial rupture and complete rupture, occur spontaneously as a result of overexertion or an accident. The patient can no longer sleep on the corresponding side of the shoulder. In the advanced stage, a lack of strength also develops, which significantly impairs everyday movements. Everyday movements, especially fetching the seat belt and slipping into the jacket, but also activities remote from the body, such as pulling a parking ticket, become a pain.

Because the pain and symptomatology classically radiate to the upper arm, it does not make the patient think primarily of a disease in the shoulder.

Diagnostics & Therapy of Rotator Cuff Rupture

The experienced orthopedist will carry out the diagnosis using various functional tests, which will give him initial clues about the tendon-muscle combination affected. Imaging examination procedures such as magnetic resonance imaging (MRI), sonography or magnetic resonance imaging underpin the examination with meaningful results. Sonography and magnetic resonance imaging are of crucial importance, as here the tendon damage can be precisely localized and the extent determined.

Depending on the situation of the shoulder tendons, therapy is initially based on symptom treatment (pain and, if necessary, existing inflammation in the case of partial ruptures that have been untreated / passed over for a long time), but subsequently usually on conservative therapy with specialized physiotherapy. Drug therapy for inflammation can be implemented with hyaluron or cortisone, and if necessary with blood plasma. This not only treats the rotator cuff rupture at the corresponding tendon, but also loosens and strengthens the healthy tissue.

It is important to train the tendons and muscles so that the torn portions of the tendons can be compensated for in everyday life. The older the patient, the more likely this conservative therapeutic procedure is to be used and the more likely the patient is to benefit from it, even though the functional demands on the joint are often lower with age. In young patients with correspondingly still high physical demands, surgical treatment and suturing of the tendon is more recommended. If necessary, the orthopedist will additionally advise you to undergo minimally invasive or invasive treatment via surgery. However, this is the last step that orthopedic specialists consider, as anesthesia required for this purpose can be an additional health burden, not only for elderly patients.

Treatment for tendon rupture of the shoulder at the Orthopaedic Center Munich East (OZMO)

At the Orthopaedic Center Munich East (OZMO), we set the course for the health of your shoulder with an accomplished trio of specialized orthopaedic specialists. Whether tendon rupture or impingement, whether conservative therapy or surgical intervention: With many years of experience and a competent team, we will be happy to assist you from the diagnostic phase to the successful completion of therapy. Schedule your appointment today to get on the road to recovery from torn shoulder tendon as quickly as possible.

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