The damages to the tendons have been the prevalent cause of pain in the shoulder. Even though these injuries often occur among sports enthusiasts, they are essentially due to the slow deterioration as an individual starts to age. It is important to note that not all tears cause significant pain. There are still a certain percentage of individuals that do not have shoulder pain that has a torn rotator cuff. Take note that there are two chief forms of rotator cuff tears – full thickness and partial thickness.
Full thickness rotator cuff tears
If an individual sustains a full thickness rotator cuff tear, the lesion can extend up the entire thickness of the affected tendon. The doctor will classify the injury based on the size and will utilize these classifications in order to determine how to treat the individual. Even though there is no uniform classification for full thickness injuries, a widely used system that is used today was developed back in 1984.
- Small – less than 1 cm in width
- Medium – 1-3 cm in width
- Large – 3.5 cm in width
- Massive – more than 5 cm in width
Partial thickness rotator cuff tears
When it comes to a partial thickness tear, the affected tendon is only partly torn. In most cases, these injuries do not include pain and commonly occur among older individuals. Just like with complete thickness tears, there is no standard organization scheme. As a result, this can lead to confusion among individuals since both systems utilize grades in order to describe the lesion, but the severity of the tissue damage for each grade differs between the two systems. An ideal way to avoid confusion is to ask the doctor and fully understand the extent of their injury and the plan of care.
The Synder classification was created in order to describe the severity of the injury. It centers on the condition of the tendon and irritation of the synovial lining via the big flap cuts. The system specifies if the tear is on the articular surface of the tendon or the surface of the bursa.
- Grade 0 – normal
- Grade 1 – swollen synovium and shallow fraying that is less than 1 cm in width
- Grade 2 – moderate rip with fiber disturbance that is 1-2 cm in width
- Grade 3 – disturbance and shattering of the tissues that is 2-3 cm width
- Grade 4 – large-sized tear that produces a flap in the tendon that is more than 3 cm in width
The Ellman classification is used to categorize partial rotator cuff tears depending on their position and the penetration of the tear. The classification also indicates if the tear is situated on the bursal or articular layer.
- Grade 1 – not more than 3 mm deep
- Grade 2 – 3- mm deep or about 50% of the thickness of the tendon
- Grade 3 – more than 6 mm deep or more than 50% of the thickness of the tendon
By being familiar with the systems used in classifying rotator cuff injuries, you can provide the appropriate first aid and if emergency care would be needed.