In this articles I want to examine a torn rotator cuff in a bit more detail. There are a range of various rotator cuff injuries and their causes but they all amount to basically the same thing a torn cuff.

I would imagine that you are here reading this because you have been diagnosed with a torn rotator cuff. Like you, I have also suffered with a torn cuff and rotator cuff injuries.

The reason I have written thus guide is purely to give you as much information as I can. Hopefully you will be able to avoid some of the problems I encountered - little information, poor diagnosis, poor doctors and a lack of insight into the importance of rotator cuff rehabilitation and rotator cuff strengthening.

So what exactly is a torn rotator cuff? Well we already know that the rotator cuff is in fact a group of four muscles that come together to form a tendon.

Tendons attach muscle to bone and this particular tendon attaches the rotator cuff muscles to the Humerus or upper arm bone. When we talk about a torn cuff or the symptoms of torn rotator cuff we are almost certainly talking about a torn rotator cuff tendon and not a torn cuff muscle.

Full or partial tear?

There is a range of severity in torn rotator cuff injuries with all rotator cuff injuries classified as full or partial tears. This is complicated only by those cases in which the tendon completely detaches.

Although any of the four rotator cuff tendons can be affected it is most often the tendon of the supraspinatus that is torn. Generally no matter which tendon or tendons are affected the tear usually occurs at the point of insertion into the humeral head.

Partial thickness tears often appear as a fraying of the still intact tendon.

Full thickness tears are complete "through and through" tears. They can range from small pin point sized tears to large button-hole size ruptures affecting the whole of the tendon.

The tendon remains substantially attached to the humeral head and as a result the rotator cuff retains its function. There may well be a loss of strength however.

Generally the above can be successfully treated by rotator cuff rehabilitation and rotator cuff strengthening exercises. A torn cuff such as is described below will more likely require surgery.

Full thickness tears may also be complicated by the complete detachment of the tendon from the humeral head. This will almost certainly result in a restriction of shoulder motion. It is also likely that the functions of the shoulder will be significantly affected.

Further classification of tears for surgery

If surgery is being considered as a treatment option for a torn cuff it is necessary to further classify the tear. This is done on the basis of both size and shape.

These classifications are necessary as they can help to determine the correct surgical methods to be applied in each case. It is probably of little importance to the patient unless you are like me and you just have to know!

Size well that's an obvious classification but shape or geometry as it is known classifies rotator cuff injuries as follows; longitudinal, transverse, U - shaped, L shaped and reversed L - shaped.

The final thing a surgeon will have to take into account is the general state of the damaged tendon itself. Any degenerative changes, the degree of fat infiltration and atrophy any loss of substance.

The final consideration for a surgeon will be the degree retraction. This is when the tendon effectively shrinks away from the site of the tear.

This is most common in a badly torn rotator cuff that has been left untreated for a long period of time. If this is a major consideration it may render the torn cuff inoperable.

If you have suffered one, get yourself a shoulder wrap or shoulder support in the mean time to ease tension and not aggravate it further.  You need to take care of your rotator cuff or it will get worse.