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Difference Between Complete Rotator Cuff Tears & Full Thickness
The rotator cuff (RTC) is located in the shoulder and is comprised of four muscles: supraspinatus, infraspinatus, teres minor and subscapularis. These muscles function together to provide dynamic stability to the shoulder joint. Rotator cuff injury is commonly seen in overhead throwing athletes 1. It is also common in adults and can occur from "wear and tear" over time. RTC injuries are classified and treated based on severity.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Stage One: Rotator Cuff Strains
There are three stages for classifying rotator cuff injuries 234. The first stage is defined by inflammation of the suprspinatus tendon and is the least severe RTC disorder. These injuries typically occur in people under age 25. People with rotator cuff strains have pain in the outside of the upper arm, when reaching overhead and when attempting to sleep on the injured arm. Loss of shoulder movement can also occur because the arm is not being moved through its normal range of motion. These injuries are treated with rest, ice, anti-inflammatories, physical therapy to relieve pain, stretching and strengthening.
- There are three stages for classifying rotator cuff injuries 2.
- People with rotator cuff strains have pain in the outside of the upper arm, when reaching overhead and when attempting to sleep on the injured arm.
Stage Two: Rotator Cuff Tendinitis
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Tendinitis and fibrosis of the RTC occurs in the second stage of RTC injury. This condition is similar to stage one injuries. Treatment for tendinitis also consists of rest, activity modification, medication, hot or cold applications and physical therapy. In addition, a cortizone steroid medication is sometimes done to decrease inflammation and pain. Chronic RTC tendinitis can lead to later RTC tears as the tendon frays due to continued inflammation.
- Tendinitis and fibrosis of the RTC occurs in the second stage of RTC injury.
Stage Three: Partial-Thickness Rotator Cuff Tears
Stage three RTC injuries include actual tearing of one or more of the four tendons. Partial-thickness tears are the less severe type of injury in this category. A partial-thickness tear means that part of the tendon is torn, but has not become detached. This type of injury is frequently treated with a course of physical therapy to attempt to restore range of motion and functional abilities. If this is unsuccessful, surgery may be indicated.
- Stage three RTC injuries include actual tearing of one or more of the four tendons.
- This type of injury is frequently treated with a course of physical therapy to attempt to restore range of motion and functional abilities.
Stage Three: Full-Thickness Rotator Cuff Tears
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Full-thickness rotator cuff tears, also called complete rotator cuff tears, occur when one or more tendons become completely detached from the bone. This condition requires surgical intervention to reattach the tendon(s) and clean out any bone spurs. A specific protocol of progressive exercises must take place after surgery to ensure the success of the repair and to help the person regain shoulder function.
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References
- Mayo Clinic: Rotator Cuff Injury: Symptoms
- Medscape: Rotator Cuff Injuries: Pathophysiology
- Medscape: Rotator Cuff Injuries Clinical Presentation
- Medscape: Rotator Cuff Injuries Treatment & Management
- American Academy of Orthopaedic Surgeons. Shoulder Impingement/Rotator Cuff Tendinitis. Updated February 2011.
- American Academy of Orthopaedic Surgeons. Rotator cuff tears. Updated March 2017.
- Factor D, Dale B. Current concepts of rotator cuff tendinopathy. Int J Sports Phys Ther. 2014;9(2):274-288.
- Rechardt M, Shiri R, Karppinen J, Jula A, Heliövaara M, Viikari-Juntura E. Lifestyle and metabolic factors in relation to shoulder pain and rotator cuff tendinitis: a population-based study. BMC Musculoskelet Disord. 2010;11:165. doi:10.1186/1471-2474-11-165
- Omid R, Lee B. Tendon transfers for irreparable rotator cuff tears. J Am Acad Orthop Surg. 2013;21(8):492-501. doi:10.5435/JAAOS-21-08-492
- Applegate KA, Thiese MS, Merryweather AS, et al. Association Between Cardiovascular Disease Risk Factors and Rotator Cuff Tendinopathy: A Cross-Sectional Study. J Occup Environ Med. 2017;59(2):154-160. doi:10.1097/JOM.0000000000000929
- Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg. 2009;18(1):138-160. doi:10.1016/j.jse.2008.06.004
- Schmidt CC, Jarrett CD, Brown BT. Management of Rotator Cuff Tears. J Hand Surg Am. 2015;40(2):399-408. doi:10.1016/j.jhsa.2014.06.122
Writer Bio
Aubrey Bailey has been writing health-related articles since 2009. Her articles have appeared in ADVANCE for Physical Therapy & Rehab Medicine. She holds a Bachelor of Science in physical therapy and Bachelor of Arts in psychology from the University at Buffalo, as well as a post-professional Doctor of Physical Therapy from Utica College. Dr. Bailey is also a certified hand therapist.