Rotator Cuff Tear
Age plays an important role in the development of rotator cuff tears. As we age, so does the rotator cuff, and weakening of the tendons increases the chances of a tear occurring. For this reason, tears are most common in adults over the age of 40. However, repeated use of the hands in the overhead position often accelerates weakening of the cuff. Individuals who perform common overhead activities, such as painters, frequently develop tendonitis, and this tendonitis may eventually progress to a complete tear in one of the tendons.
Tears are also common in certain athletes who use repetitive overhead motions, such as cricket bowlers, swimmers, and tennis players. In some cases, a tear can be sustained from a direct blow - a fall from a bicycle, for example.
With a rotator cuff tear, you may experience pain primarily on top and in front of your shoulder. Sometimes, pain may occur at the side of your shoulder, and it is usually worse with any activity that forces you to reach above the level of your shoulder. You may also experience weakness and stiffness, and it may be difficult to perform simple overhead activities like placing dishes in the cupboard. Some people with tears can't lift their arm to comb their hair. Stiffness may result from the inability to move your shoulder, and this stiffness may become progressive.
Often with rotator cuff tears, bursitis (inflammation of the bursa, the small sac of fluid that surrounds the joint) will occur, which may cause a mild popping or crackling sensation in the shoulder. The tear itself may rub and cause this sensation. You may also have difficulty sleeping on the shoulder at night.
When a rotator cuff tear begins to interfere with normal activities, arthroscopic shoulder surgery may be necessary to restore your shoulder's full functional abilities. Then you can get back to the activities you enjoy, or simply enjoy a night's rest.
Shoulder instability occurs when the structures that surround the shoulder joint loosen and cannot maintain the ball within its shallow socket. If the joint is too loose, it may slide partially out of place, a condition known as "shoulder subluxation".
When the joint comes completely out of place, also called "shoulder dislocation", the ligaments that support the shoulder are torn. Normally, this injury does not heal tightly, making the shoulder prone to repeat dislocation and additional episodes of instability.
With shoulder instability, some activities can create sudden pain, a sense of arm deadness, or the feeling of your shoulder slipping out and back into the joint. If you experience complete dislocation, you may have severe pain along with the inability to "reset" the joint.
Some shoulder instability can be treated with rest followed by rehabilitation, however, in certain instances the surgeon may recommend surgery - these include more complicated injuries, cases of recurrent instability, and first-time dislocations in younger patients who have a high risk of recurrence, further damage, or limited activity.