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Diagnosing Rotator Cuff Tears

The role of the rotator cuff is to stabilize the ball and socket of the shoulder joint and this gets done with the help of a group of four muscles – the Supraspinatus, infraspinatus, teres minor and the subscapularis. When there is a tear in the body or tendon of any one of these muscles then this could lead to a rotator cuff tear. In fact, the injuries to the rotator cuff happens to be the most common among shoulder injuries.

The symptoms of a torn rotator cuff muscle can be different based on which muscle is injured 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. Rotator cuff tears from a sudden injury will generally cause more intense pain.

Getting a rotator cuff tear diagnosed correctly is the first step towards correcting it with specific treatments and rehabilitation. Though the various imaging tests like X-rays, Ultrasound, MRI can help with the diagnosis, doctors and physiotherapists often rely on a series of functional tests that could be used to diagnose torn rotator cuffs. Some of these tests can correctly indicate a rotator cuff injury while also ruling out similar injuries like nerve impingement or torn labrum or even a shoulder instability.

The doctor will be required as part of these tests to closely examine the different parts of the shoulder and they will even ask you to try to move your arm into different positions in order to test the strength of the muscles around shoulder and in arms. Let’s look at some of the commonly used functional tests that can help confirm a rotator cuff tear.

  • Apley Scratch Test – Tests for Rotator cuff injuries or limited range of motion. This test requires you to one hand behind your back and the other over your shoulder. Pain or movement limitation can confirm a rotator cuff injury.
  • Hornblower’s sign test – In this test the 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. An inability to rotate can ascertain a damage to the teres minor rotator cuff muscle.
  • Bear hug test – This test requires you to 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. A weakness can mean damage to the subscapularis rotator cuff muscle.
  • Drop-arm test – In this testyou will raise your arms to the side as high as possible and lower them to 90 degrees. An inability to hold your arms at 90 degrees will confirm a torn rotator cuff.
  • Jobe’s test – The doctor will ask you to liftyour arms against a doctor’s resistance with your thumbs facing downward. Pain or weakness on the injured side can mean a Rotator cuff injury to supraspinatus or infraspinatus muscles.

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