Wear, Tear & Shoulder Care: Understanding Rotator Cuff Injuries

Shoulder pain that lingers or keeps you up at night isn’t always just “soreness.” For many adults over 40, it can be a sign of a rotator cuff tear. While these injuries can be associated with dramatic sports moments, according to our Orthopedic ONE fellowship-trained surgeon, Dr. Kenneth J. Westerheide, many rotator cuff tears actually occur in everyday patients, not just athletes, and sometimes in people who have never played a sport at all.

Understanding the Rotator Cuff

“The rotator cuff is a group of four muscles in your shoulder,” Dr. Westerheide explains. “There’s one in the front, one in the back, and two on the top, and their role is to help rotate the arm and initiate movement, while keeping the humerus (bone of the upper arm) both centered in the socket and attached to the shoulder blade.”

This balance enables the shoulder, the most mobile joint in the body, to function smoothly during daily activities such as lifting, reaching, or rotating the arm overhead. Thus, tearing the rotator cuff can weaken the whole shoulder and dramatically complicate everyday life.

Not Just Another Sports Injury

Many people are surprised to learn that rotator cuff tears are rarely linked to sports alone. In fact, they often develop slowly over time. Dr. Westerheide shares: “Fifty- to sixty-year-olds will say, ‘Well, I don’t play sports.’ But that’s not how this happens. It’s usually degenerative and related to age… As we get older, the cuff gets more fragile, like a rope. More use equals more fraying.”

Rotator cuff injuries can occur due to a combination of age-related changes and occasional trauma, such as falling on an outstretched arm. What makes the pain concerning enough to see a doctor, though? According to Dr. Westerheide, patients should pay attention when everyday life becomes difficult. “I saw a gentleman who’s 50, and he can’t work out at the gym anymore. He has trouble reaching into cabinets or the refrigerator, difficulty lifting his arm, and has significant night pain; he can’t sleep. Those are very common symptoms.”

Pain that interferes with sleep, limits overhead reach, or causes noticeable weakness is a sign that it’s time to seek expert medical care.

Treating Rotator Cuff Tears at Orthopedic ONE

Treatment at Orthopedic ONE always starts with a diagnosis. For rotator cuff injuries, this process typically begins in the office with X-rays and a physical exam. Our physicians will assess the strength of each of the four tendons to identify weaknesses. If the exam suggests a significant tear, an MRI will be ordered for confirmation.

However, not every rotator cuff tear requires surgery. Dr. Westerheide explains: “If the rotator cuff is only mildly torn, less than 50%, then treatment often just includes physical therapy and possibly a cortisone injection.” Physical therapy focuses on strengthening the surrounding muscles, restoring mobility, and reducing pain. Many patients find that they can return to their normal activities without the need for surgical intervention.

When tears are more severe or don’t respond to conservative care, though, surgery may be the next step. Today, most procedures are performed arthroscopically, which means using small incisions and a camera for guidance.

“It’s an outpatient surgery, so there are no big incisions,” says Dr. Westerheide. “In many cases, we insert little absorbable plastic anchors to reattach the tendon back to bone, which then dissolve in one to two years, so that’s a huge benefit.” Regardless of the care needed or the specific technique used, our team will explain each process in detail, ensuring patients not only know their options but fully understand them.

The Road to Recovery

Rotator cuff injuries may be common, but they are also highly treatable. With timely diagnosis, the right treatment plan, and guidance from an experienced care team, patients can look forward to restored mobility and pain relief. As Dr. Westerheide reminds his patients, “the goal isn’t to take away activity but to give it back.”

Recovery takes time but follows a steady progression. “Patients think they’ll be locked up in a sling for months and months; that’s a misconception,” Dr. Westerheide explains. “I actually have them come out of the sling the day after surgery to start gentle range of motion exercises.” From there, physical therapy gradually restores motion and builds strength.

By following the process step by step, patients can return to daily life, exercise, and hobbies after six months, without the pain that once limited them.

Prevention and Shoulder-friendly Habits

While age is often the most significant factor, there are ways to protect the shoulder. Dr. Westerheide recommends exercises that strengthen the rotator cuff while being mindful of lifting positions. Keeping weights below shoulder level and avoiding repetitive overhead presses can help reduce unnecessary strain.

“Rotator cuff exercises, keeping weights below shoulder level, keeping elbows closer to the body, those things make a difference,” he notes. One of the most critical factors in a successful recovery, though, is seeking care sooner rather than later. “Timing is of the essence,” says Dr. Westerheide. “There’s a lot of research showing that when the tear is fixed sooner, within one to three months, the results are better.”

Experience You Can Count On

When it comes to rotator cuff injuries, experience and compassion go hand in hand. Many of our specialists are fellowship-trained in the treatment of shoulder injuries, including the latest arthroscopic advancements. However, it’s not just their technical skills and decades of experience that make Orthopedic ONE stand out, but rather the way we connect with our patients.

“Our physical therapists are very well trained and highly experienced,” Dr. Westerheide notes. “It’s a great combo, with constant communication between our doctors and therapists.” That seamless collaboration ensures patients feel supported from the first appointment through rehabilitation and beyond. For patients, this means access to advanced treatments, as well as a trusted team committed to helping them return to the activities they love.

If you’re experiencing shoulder pain or have any related questions, please don’t hesitate to contact our team at Orthopedic ONE. Helping you stay active, heal, and thrive are our top priorities!