A torn rotator cuff doesn’t always cause pain, and severe pain from the rotator cuff doesn’t necessarily mean a tear.

Cortisone vs. surgery is not as absolute as you think.

“Rotator cuff tears are extremely common,” says John-Paul H. Rue, MD, orthopedic sports medicine surgeon with Orthopedics and Joint Replacement at Mercy Medical Center in Baltimore, MD.

“Not all rotator cuff tears are symptomatic and certainly not all tears need surgery,” continues Dr. Rue.

“A cortisone injection is often used to help determine if the pain that someone has is due to inflammation in the shoulder or truly from the rotator cuff tear.”

What exactly is the rotator cuff?

It’s comprised of four tendons and the muscles that they are attached to. The muscles are:

• Supraspinatus
• Subscapularis
• Teres minor
• Infraspinatus

Shutterstock/Alila Medical Media

These are small muscles and are not primary movers when it comes to force production.

For example, the medial deltoid muscle is the primary mover when you lift a dumbbell out to your side. However, the supraspinatus and its tendon assist with this motion.

“In some cases you may have had a rotator cuff tear for some time without much difficulty or limitations from it, and then something happens, like a new injury or overuse activity, causing acute or sudden pain,” explains Dr. Rue.

“In these cases, a cortisone injection can be very useful to decrease the inflammation and allow you to rehabilitate your shoulder and hopefully get you back to where you were.

“If someone has continued pain despite a cortisone injection, or has severe weakness due to a tear, surgery to repair the rotator cuff tear may be required.”

Dr. Rue specializes in prevention and treatment of sports and exercise injuries. His primary focuses are knee, shoulder and elbow injuries including ACL and cartilage injuries, rotator cuff injuries and overuse tendonitis.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health. 



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