Yourrotator cuffis a group of four muscles that stabilizes the ball and socket of your shoulder joint. These muscles are often referred to as the SITS muscles, which stands for:
A rotator cuff tear occurs when you have a tear in the body or tendon of one of these muscles.
Injuries to the rotator cuff are the
Let’s examine the tests that doctors and physiotherapists often used to diagnose torn rotator cuffs. We’ll also break down treatment options.
A doctor or physiotherapist can use one of more than
In some cases, a doctor may also recommend imagining tests to diagnose a torn rotator cuff.
Apley scratch test
How it’s performed:You will reach one hand behind your back and the other over your shoulder.
What it tests for:Rotator cuff injuries or limited range of motion
Positive result:Pain or limitation on the injured side compared to the uninjured side
Hornblower’s sign test
How it’s performed:A doctor will raise your arm to your side and bend your elbow to 90 degrees. You will then externally rotate your arm as the doctor resists.
What it tests for:Damage to the teres minor rotator cuff muscle
Positive result:An inability to externally rotate
Bear hug test
How it’s performed:You’ll put the hand of your injured arm on your opposite shoulder. A doctor will then try to pull your hand off your shoulder while you resist.
What it tests for:Damage to subscapularis rotator cuff muscle
Positive result:Weakness or pain in your shoulder
Neer’s sign
How it’s performed:A doctor will stabilize your scapula, rotate your arm internally, and flex your arm.
What it tests for:Shoulder impingement
Positive result:Pain while lifting arm
Hawkins’ test
How it’s performed:Your arm will be flexed forward by a doctor and then bent at the elbow 90 degrees. They will then rotate it across your body.
What it tests for:Shoulder impingement
Positive result:Pain when your arm is internally rotated
Drop-arm test
How it’s performed:You will raise your arms to the side as high as possible and lower them to 90 degrees.
What it tests for:Torn rotator cuff
Positive result:An inability to hold your arms at 90 degrees because of pain
Cross-arm test
How it’s performed:Your arm will be lifted straight and in front of you and brought across your body.
What it tests:Arthritis of your acromioclavicular joint
Positive result:Pain where your scapula and collar bone meet
Spurling’s test
How it’s performed:You will look toward your painful shoulder and a doctor will apply a light pressure to the front of your head with their hand.
What it tests for:Cervical nerve root disorder
Positive result:Pain in your shoulder or arm
Apprehension test
How it’s performed:Your arm will be lifted to your side with your elbow bent at 90 degrees. A doctor will rotate your hand behind you while stabilizing your shoulder.
If the apprehension test is performed while lying down and is positive, the relocation test is then conducted by applying down pressure over the shoulder. This stabilizes the shoulder. If it provides relief, this is a positive test and further supports the diagnosis of shoulder instability.
What it tests for:Instability in the front part of your shoulder joint
Positive result:Discomfort or pain in the test position
Sulcus sign
How it’s performed:A doctor will stabilize your arm at the shoulder while gently pulling on your arm.
What it tests for:Shoulder instability
Positive result:A greater than normal amount of depression of your shoulder joint
Yergason test
How it’s performed:You’ll flex your arm to 90 degrees and the doctor will shake hands with you while rotating your hand away from your body.
What it tests for:Instability of your shoulder joint or biceps tendonitis
Positive result:Pain along your biceps tendon
Speed’s maneuver
How it’s performed:You’ll flex your arm straight in front of your body with your palm facing upward while a doctor provides resistance.
What it tests:Biceps tendon instability or tendonitis
Positive result:Pain along your biceps tendon
“Clunk” sign
How it’s performed:While you lie on a table, a doctor will rotate your upper arm as they lift your arm over your head.
What it tests:Labral disorders
Positive result:The presence of a clunking sound
Jobe’s test (empty can test)
How it’s performed:You will attempt to lift your arms against a doctor’s resistance with your thumbs facing downward
What it tests:Rotator cuff injury to supraspinatus or infraspinatus muscles
Positive result:Pain or weakness on your injured side
Imaging tests
A doctor might request one of several imaging tests to diagnosis your torn rotator’s cuff such as an x-ray, ultrasound, or magnetic resonance imaging(MRI).
- X-rayswon’t show a torn rotator cuff but can rule out other causes of pain, such as bone spurs.
- Ultrasoundscan be used to monitor the muscle and tendons while you move your arm and compared to your other arm.
- MRIsuse radio waves to create a picture of the bone, muscles, and connective tissue in your shoulder.
Symptoms of a torn rotator cuff muscle can vary depending on which muscle you injure and how severe your injury is. The severity of the injury can vary from microtears to complete tears and can be caused by either a sudden injury or repeated stress over time. Tears from a sudden injury generally cause more intense pain.
Some of themost common symptomsinclude:
- pain when lying on your injured shoulder
- 当解除你痛苦r arm or rotating at the shoulder joint
- weakness in the injured arm
- cracking or popping in certain positions
If you suspect you have a torn rotator cuff, it’s a good idea to avoid activities that give you pain and rest your shoulder. A doctor can confirm the diagnosis and recommend the best treatment options.
Non-surgical options
Most rotator cuff tears don’t need surgery to heal. Some non-surgical treatment options include:
Conservative treatment
The most basic form of treatment is to rest the injury. Nonsteroidal anti-inflammatory drugs such asibuprofencan help reduce swelling and manage pain. A doctor may prescribe a sling in to help you protect your shoulder.
Injections
If your pain isn’t responding to rest, a doctor may recommend asteroid injection, which reduce inflammation and provide pain relief.
Physical therapy
Undergoing physical therapy can help you strengthen your shoulder and restore your range of motion. A therapist can give you specificexercisesand stretches to help you regain function and prevent re-injury.
Surgical options
Surgery may be needed for more severe rotator cuff injuries. Somesurgical optionsinclude:
Open repair
在一个开放的修复,外科医生让一个切口over your shoulder and detaches your deltoid muscles to access the injured rotator cuff muscles. Open repair is the most invasive technique and may be used if there’s extensive damage or if you need a tendon transfer or shoulder replacement.
Tendon transfer
During atendon transfer, your surgeon will take a tendon from one part of your body and use it to repair the damaged tendon. It may be performed if the tendon is too damage to be reattached.
Mini-open repair
During a mini-open repair, your surgeon will make a smaller incision than they do during full open repair. Your surgeon won’t need to detach your deltoid muscle to access your rotator cuff.
Arthroscopic repair
An arthroscopic repair is the least invasive method. The surgery is performed with a small camera called an arthroscope and very tiny instruments to minimize the recovery time.
Rotator cuff tears are common injuries caused by damage to the muscles or tendons that stabilize your shoulder joint. They can be diagnosed by using a number of physical tests and imaging techniques.
- Dang A, et al. (2018). Rotator Cuff Disease: Treatment Options and Considerations. DOI:https://doi.org/10.1097/JSA.0000000000000207
- Jain NB, et al. (2013). Clinical examination of the rotator cuff. DOI:https://doi.org/10.1016/j.pmrj.2012.08.019
- 肩袖损伤。(2020)。https://www.mayoclinic.org/diseases-conditions/rotator-cuff-injury/diagnosis-treatment/drc-20350231
- 肩袖损伤。(2020)。
https://www.ncbi.nlm.nih.gov/books/NBK547664/ - Rotator cuff tears. (2017).https://orthoinfo.aaos.org/en/diseases–conditions/rotator-cuff-tears/
- Rotator cuff tears: surgical treatment options. (2017).https://orthoinfo.aaos.org/en/treatment/rotator-cuff-tears-surgical-treatment-options/
- Woodward TW, & Best TM. (2000). The painful shoulder: part I. Clinical evaluation.https://www.aafp.org/afp/2000/0515/p3079.html