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Rotator Cuff Tear and Frozen Shoulder - How Are the Two Different?

Most of us do not realize how often we use our shoulder until we feel pain or are unable to move it at all.

Most of us do not realize how often we use our shoulders until we feel pain or cannot move it at all. Shoulder conditions lead to pain, stiffness, and reduced range of motion. Rotator cuff tear, and frozen shoulder are two of the most common shoulder conditions orthopedic surgeons treat every day. A rotator cuff tear is often mistaken for a frozen shoulder, so we explain how different the two are.

What Is A Rotator Cuff Tear?

The shoulder joint is bounded by a group of muscles called the rotator cuff. These muscles work in tandem with tendons to make the shoulder joint stable so that you can move your arms easily. In other words, they are extremely crucial for the proper functioning of the shoulder joint.

A Tear In The Rotator Cuff Can Happen In Two Ways:

Partial Tear: In partial tear, the tendon is partially damaged.
Complete Tear: In complete tear, the tendon is pulled off the bone completely, causing severe damage to the shoulder.

Rotator Cuff Tear Causes

Rotator cuff tear may result from an acute injury, say fall, in adults. It can also be caused by age-related wear and tear, resulting in the degeneration of the tendon. Initially, you will experience pain in the front of your shoulder, which travels down your arm. If you indulge in activities like lifting, the pain may worsen. Also, it may aggravate if you try sleeping on the affected side. Consequently, you may note weakness in your arm and difficulty accomplishing daily tasks like combing your hair or reaching behind your back.

Rotator Cuff Tear Symptoms

In the beginning, you may not observe the prominent rotator cuff tear symptoms except the pain while using the arm or pain during the night, which could interrupt your good night’s sleep. In case the tear is insignificant, your arm may still fully function. But when it becomes significant, you may not be able to lift your arm(s) at all. In rare cases, it may lead to a condition called shoulder arthritis.

Rotator Cuff Tear Diagnosis

At first, the doctor performs the clinical examination of the shoulder joint treatment. An X-ray is also taken into account, followed by an MRI scan. MRI is done to determine the extent of the tear and calculate the amount of retraction and fatty degeneration in the rotator cuff.

Rotator Cuff Tear Treatment

Arthroscopic tendon repair is one of the best arthroscopy treatment options available for rotator cuff tear. Several keyholes are made around the shoulder, and the surgery is performed through these keyholes with the help of a camera and other instruments. Suppose the rotator cuff is in its early stages. In that case, the bony spur is removed from underneath the acromion to make space for the rotator cuff and reduce the amount of rubbing, which may further degrade the muscle. The treatment is called subacromial decompression.
In case of an extensive tear, surgery is needed, in which sutures are employed to repair the tear.

What Is A Frozen Shoulder, And How Is It Different?

Also known as adhesive capsulitis, frozen shoulder is a condition that develops when your shoulder joint is compromised. It also affects the shoulder capsule – a tissue that encircles the shoulder joint.

When you start developing a frozen shoulder, the shoulder capsule becomes thick and stiff. As a result, you find moving your arm or shoulder difficult. Also, it results in the loss of synovial fluid, which helps keep the joint lubricated for a smooth movement. Most physicians segregate frozen shoulders into three stages.

Freezing stage

In the first stage, the shoulder area becomes highly painful, and people face difficulty in free movement. This condition ranges between 6 and 9 weeks.

Frozen stage

This stage brings a reduction in shoulder pain. However, the stiffness persists. This stage lasts anywhere from 4 to 6 months.

Thawing stage

In this stage, the shoulder pain slowly reduces, and people gain strength. It takes nearly six months to 2 years for people to return to normal.

Symptoms of Frozen Shoulder

The primary symptom of a frozen shoulder is excruciating pain in the shoulder. This pain limits the area of free movement of the shoulder and arms. People with this condition also experience dull pain in one shoulder while performing usual tasks. For better diagnosis, physicians suggest a frozen shoulder test to people.

Frozen Shoulder Diagnosis

Doctors perform two types of physical tests to diagnose frozen shoulders.

  1. Active test: In this test, patients need to move their shoulders by themselves.
  2. Passive test: In this test, doctors assist patients during shoulder movement to note the difference.

Sometimes, doctors also recommend X-ray, MRI, or ultrasound for a frozen shoulder test.

Frozen Shoulder Treatment

Most physicians prescribe ibuprofen and aspirin to relieve the pain due to frozen shoulders. However, in severe cases, the following treatments give better relief to people:

  1. Corticosteroid injection.
  2. Joint distension by injecting sterile water.
  3. Surgery using thin pencil-sized tools.
  4. Physical therapy.


Difference Between Frozen Shoulder And Rotator Cuff

A frozen shoulder is often confused with the rotator cuff. However, both conditions have a significant difference. Rotator cuff patients can lift their shoulders without assistance. In contrast, with frozen shoulders, patients face difficulty in raising their shoulders by themselves.

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A lot of times, people confuse frozen shoulder with rotator cuff tear. However, the rotator cuff tear symptoms are different from frozen shoulder. The arm’s range of motion may be limited with a rotator cuff tear, but you can still lift it yourself. In contrast, a frozen shoulder is characterized by an aching pain and majorly follows stable immobilization. 
If you look at the medical statistics about frozen shoulder, you will find that women are affected by this condition more than men.

Also, it is more common in people in their 50’s and 60’s. However, the condition can improve significantly with proper treatment, which includes the intake of non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen that help relieve pain. Other treatment options like joint distension and surgery are considered if the symptoms are severe.

Rotator cuff and frozen shoulder cause severe pain to the patients and limit free shoulder movement. However, they both have different treatment options. Frozen shoulder can be treated with counter medications, while surgery is the best treatment option for the rotator cuff.


Can a torn rotator cuff be misdiagnosed as a frozen shoulder?

Proper physical frozen shoulder test is enough to perform the correct diagnosis of the disease. Although both conditions concern shoulder movement, in frozen shoulders, patients can not increase their range of motion even with external assistance.

Is frozen shoulder worse than rotator cuff?

In the rotator cuff, patients experience shoulder pain, but they can perform the movement without assistance. However, patients with frozen shoulders face extreme difficulty performing regular tasks, even with help.

How does it feel in a partially torn rotator cuff?

In a partially torn rotator cuff, patients experience shoulder pain while lifting objects. They feel a popping sensation or clicking sound while moving their arms. The shoulder pain increases while a patient sleeps or rests.

How do you tell if the rotator cuff is torn or strained?

Both conditions limit the arm's free movement by causing severe pain. However, in rotator cuff tearing, the tendon completely separates from the shoulder bone, forming a hole. The tendon stretches but remains attached to the bone in a strained rotator cuff.

Does a torn rotator cuff hurt all the time?

A torn rotator cuff does not hurt all the time. However, people generally feel sharp pain while sleeping, performing specific arm movements, or lifting objects.

Can you see the frozen shoulder on MRI?

Magnetic Resonance Imaging, commonly known as MRI, is a method to diagnose torn ligaments, tumors, gallstones, etc. This diagnosis method provides an excellent way to diagnose frozen shoulders.

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