Rotator Cuff Tear Symptoms: Do Small Rotator Cuff Tears that Don’t Hurt become Bigger Tears that Hurt?
Do rotator cuff tear symptoms come from small problems that get bigger? For example, does it make sense to pay attention to asymptomatic rotator cuff tears or ignore them? These past several years we’ve seen data showing that knee meniscus tears in middle aged and elderly patients without knee pain are as common as wrinkles or grey hair. For example, there were no more meniscus tears in patients with knee pain as those without knee pain. Using this same theory, you would believe that ignoring small rotator cuff tears that aren’t causing pain would be a good idea, as maybe they are like grey hair, just a feature of aging rather than a real problem. The findings of a recent study would suggest that maybe this isn’t a good idea. The authors took 50 patients in Norway who had asymptomatic rotator cuff tears and followed them using ultrasound and MRI imaging. Eighteen of the 50 patients developed shoulder pain during the three years and their rotator cuff tears grew about three times more than those who didn’t develop pain. About a third of the patients who developed shoulder symptoms had new rotator cuff muscle atrophy and fatty atrophy as compared to only 12% and 4% of the asymptomatic group. In addition, the group that developed symptoms had much more bicep tendon pathology than the group that didn’t. The upshot? Based on this study, it may make sense to watch small rotator cuff tears and if they begin to advance, treat them with biologic agents like PRP and stem cells early, before they begin to cause more problems.