Rotator Cuff Injury Treatment Singapore

A rotator cuff tear is a rupture of the sleeve of tendons (rotator cuff) surrounding the ball of your shoulder joint (which comprises a ball and socket joint). The rotator cuff tendons connect muscles of the shoulder blade to the upper arm bone (humerus). These muscles, in turn, provide stability and mobility to your shoulders.

What is a Rotator Cuff Tear?

Rotator cuff tears are extremely common. It is estimated that 21% of the population have such rotator cuff injuries, although the incidence is much higher in the older population.

Another interesting fact is that many people with this type of rotator cuff injury may not be symptomatic at all! In fact, the incidence of asymptomatic rotator cuff tears appears to be higher in older patients.

It is estimated that up to 2/3 of patients in their 60s with rotator cuff injuries may not be symptomatic. The remaining 1/3 of patients seek help because of pain in their shoulders, especially during movements of their arms at their shoulders.

What Causes Rotator Cuff Tear?

Sometimes, patients may develop rotator cuff tears without remembering any inciting event or injury. This rotator cuff injury can occur in many instances, and a tear in the shoulders is one of the most common occurrences.

Here are some other causes of rotator cuff tears:

Overuse, especially overhead activities
Wear and tear over time
Acute injury

Types of Rotator Cuff Tears

Partial-Thickness Rotator Cuff Injury
This injury affects only part of the tendon, causing fraying but not a complete severance. It results from wear or sudden stress, leading to pain and arm weakness when lifting.
Full-Thickness Rotator Cuff Injury
A more severe condition where the tendon is fully ruptured, significantly impairing shoulder function. Symptoms include intense pain, especially at night, and a notable weakness during overhead activities. Surgery may be necessary to mend the tendon.
Acute Rotator Cuff Injury
Typically caused by a sudden, impactful action like a fall or lifting a heavy object, this injury brings immediate, severe shoulder pain. The severity can vary based on the tendon damage extent.
Degenerative Rotator Cuff Injury
Chronic wear due to ageing or repetitive stress leads to these injuries, more frequent in older individuals or those performing repetitive overhead motions. Symptoms, including shoulder weakness and discomfort, gradually worsen with activity.
Tendinopathy
Characterised by chronic tendon overuse, causing swelling and irritation but not full tearing. It presents with pain and restricted movement, often seen in athletes or individuals with repetitive arm use.

Symptoms of Rotator Cuff Tear

Shoulder pain and tenderness
Discomfort and sensitivity in the shoulder, particularly when pressure is applied or when moving the arm in certain positions. The pain often worsens at night, affecting sleep.
Dull ache
A constant, nagging ache in the shoulder is common with rotator cuff injuries. This dull pain typically intensifies with movements that involve lifting the arm or stretching it overhead.
Arm weakness
Damage to the rotator cuff can lead to a noticeable decrease in arm strength, making it challenging to perform routine tasks such as lifting objects or pulling.
Difficulty reaching behind the back or out to the side
Rotator cuff injuries may restrict your ability to move your arm in specific directions, including reaching behind the back or extending the arm out to the side, often due to pain or mechanical limitation in the shoulder.
Decreased range of motion
There is often a reduced ability to move the shoulder through its full range of motion, making it difficult to perform overhead activities or movements across the body.

Tips to Prevent Rotator Cuff Tears

Strengthen Shoulder Muscles
Regularly perform exercises that strengthen the shoulder muscles, particularly the rotator cuff and scapular stabilisers. This can help support the shoulder joint and reduce the risk of injuries.
Improve Flexibility
Incorporate stretching into your daily routine to improve the flexibility of the shoulder muscles and tendons. This can help maintain a healthy range of motion and prevent injuries.
Use Proper Techniques
Whether you’re participating in sports or performing physical tasks, using the correct techniques is crucial. Avoid sudden, awkward movements and ensure you use ergonomic practices when lifting or reaching overhead.
Take Breaks
If your activities involve repetitive shoulder movements, take regular breaks to prevent overuse, which is a common cause of rotator cuff injuries.
Warm-Up Properly
Always warm up before engaging in physical activity to prepare the muscles and tendons for the stress of exercise, reducing the likelihood of injury.
Manage Workload
Gradually increase the intensity and duration of any new activity to give your shoulders time to adapt without becoming overstressed.
Seek Professional Guidance
Consult with a physiotherapist or a shoulder specialist for personalised advice on shoulder exercises and injury prevention strategies.

How Is Rotator Cuff Tear Diagnosed?

X-Ray

Many doctors may begin their investigations with x-rays for the shoulder. X-rays are excellent investigations for viewing bony and joint problems. To me, x-rays provide me with a “bird’s eye view” of the problem.

Ultrasounds

Ultrasound scans are generally more useful in the diagnosis of rotator cuff tears than x-rays. In the hands of an experienced ultrasonographer, it is possible to accurately diagnose rotator cuff tears and shed light on its severity.

MRI Scan

An MRI (magnetic resonance imaging) scan is by far, the most informative scan, and it is my investigation of choice for rotator cuff tears. It gives excellent information with regards to the rotator cuff, presence of any tears of the rotator cuff tendons, state of the rotator cuff muscles etc.

Is rotator cuff tear affecting your quality of life, and your ability to perform everyday activities such as working, playing sports and wearing your clothes?

Dr. Bryan will assess your symptoms in detail before recommending the right treatment plan for your condition.

How To Treat Rotator Cuff Tear?

Rotator cuff tears can range in severity greatly. Treatment depends very much on how bad the tear is. We usually classify tears into the following: partial tears, small full thickness tears, medium tears, large tears, massive tears and finally, cuff tear arthropathy (where the joint is permanently damaged due to the presence of severe rotator cuff tears).

Common treatment methods include:

Rest
Warm compression to minimise pain.
Anti-inflammatory medications such as ibuprofen, etoricoxib and naproxen
Strengthening exercises and physical therapy
Cortisone injection to reduce inflammation (controversial)

Surgery may be recommended for more severe cases of a rotator cuff tear or when non-surgical treatment options fail to alleviate symptoms. Surgery to repair a torn rotator cuff typically involves re-attaching the tendon to the humerus.

Anatomy of the Shoulder Joint

The shoulder joint is made up of 3 bones: the shoulder blade (scapula), the humeral head and the collar-bone (clavicle).

Movements around the shoulder involve 3 separate articulations: the glenohumeral joint, the acromioclavicular joint and the scapulothoracic articulation. When the arm is raised, the majority of movement occur at the glenohumeral joint and the scapulothoracic articulation.

Four (4) muscles are attached to the scapula and send their respective tendons across the glenohumeral joint and attach to the humerus just beyond the humeral head. These 4 tendons are collectively known as the rotator cuff.

You can think of the muscles as motors and their tendons as pulleys. Contractions of the muscles will hence bring about movement at the joint that their tendons cross.

Frequently Asked Questions

How To Repair Rotator Cuff Injury?

How To Heal A Rotator Cuff Injury Without Surgery

Should You Rest Or Exercise A Rotator Cuff Injury

How To Strengthen Your Rotator Cuff After Injury

What will the doctor do?

Is a rotator cuff tear serious? When should I visit a doctor?

How is rotator cuff surgery performed?

What kind of anaesthesia will I require?

Can I return home on the same day as the surgery?

How long will I take to recover?

Billing & Payment

Medisave & Insurance Claims

The following are accredited For Singaporeans, Singapore Permanent Residents and Foreigners. If your insurance is not listed, you will still be able to make claims for eligible procedures! We have experience processing claims from many other various insurance providers. Please contact us if you have any queries.

WHAT’S THE FIRST STEP?

Embark on Your Road to Recovery With Dr Bryan Tan

STEP 1

Book An Appointment
With Dr. Bryan

Our friendly clinic staff will assist you with your registration, ensuring an efficient and hassle-free process for you. Fill up this form to schedule an appointment with Dr. Bryan.

STEP 2

Initial Consultation & Diagnosis of your Condition

During your consultation, Dr. Bryan will evaluate your medical history and the pain you are experiencing. You may also ask Dr. Bryan any questions you may have about your condition.

STEP 3

Treatment & Follow Up Visits With Dr. Bryan

After your consultation with Dr. Bryan, our friendly clinic staff will assist you with your follow-up appointment, and provide you with instructions/information for any prescribed treatment plans from Dr. Bryan.

Take the First Step

Book An Appointment

Leave us a few details and Dr. Bryan will get back to you shortly.