Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I have a small rotator cuff tear I didn't even know I had. When I fell last week, they did an X-ray and MRI and found it. Evidently, it's been there awhile and wasn't from my fall. Should I do anything about it?

Answer:

Your orthopedic surgeon is the best one to advise you on this. The MRI will show the size (length and width) and depth of the tear. It will show which tendon(s) is affected. From there, the surgeon can evaluate your shoulder motion, strength, and function and get an idea of whether or not the tear has affected any of these factors. Although the tear size is small and asymptomatic (without symptoms or pain free), there is a concern that the tear could get worse. Tear progression is also possible as a result of the fall if the force of the trauma disrupted the rotator cuff but the MRI didn't show it yet. Surgeons are studying rotator cuff tears like yours -- those that are present but unknown because they don't cause any pain. There are questions that remain unanswered. For example, why are some rotator cuff tears (RCTs) painful while others are not? And what makes them convert from a pain free (asymptomatic -- without symptoms) to a symptomatic tear? If we knew the answers to these questions, we might be able to prevent rotator cuff tears from getting worse and becoming painful. What we know so far is that the larger the tear at first, the greater the chances of pain developing. And rotator cuff tears on the dominant hand side are more likely to develop painful symptoms. You may be in a wait-and-see situation. If your physician finds muscle weakness or loss of normal shoulder motion, you may be a good candidate for a short-course of rehabilitation. A physical therapist will evaluate what you need and set you up on a strengthening and motion program designed to restore full, normal shoulder motion. This may help keep that tear from getting worse or rupturing completely. Nathan A. Mall, MD, et al. Symptomatic Progression of Asymptomatic Rotator Cuff Tears. In The Journal of Bone and Joint Disease. November 17, 2010. Vol. 92A. No. 16. Pp. 2623-2633.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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