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While Thomas Avera’s rotator cuff injury was the result of a major accident, Dr. Paul Brady says many people may have a torn rotator cuff and never know it until it becomes so painful they seek help.

“In about 80 percent of rotator cuff tears, you can’t put your finger on when they happened,” said Brady. “It’s one of those things that can happen slowly over time, and a lot of patients wait until they can’t sleep, can’t comb their hair or whatever and they wait until the last minute to go to the doctor.”

In fact, Brady says torn rotator cuffsaren’t just something that a baseball pitcher or tennis player goes through – they are often the result of a repetitive motion over time. “Sometimes, it’s just a lifetime of activity – wear and tear – or bone spurs can irritate the rotator cuff and weaken it,” he said. “In the natural aging process, all of our tendons get a little weaker over time. If we stay active, that process is much slower. So, the more active you are, the less weak your tendons are going to become. People who become very inactive, their tendons become almost brittle. Think of a nice fresh rubber band– you can hardly break it. But if you have one that sits in the drawer a long time and you pull it, it just crumbles. That’s an extreme example but it’s not far from the truth.”

Another common cause of rotator cuff injuries, Brady says, are lawnmowers or other outdoor equipment that start with the pull of a rope.

“Particularly, if it ‘catches’ on them or if the rope breaks – those are two things I’ve seen in a bunch of patients,” said Brady. “They say, ‘As I was pulling it, the rope broke and my arm gave and I knew something happened.’ So, be careful starting your lawnmower.”

Brady says shoulder or arm pain, pain at night and pain with overhead activities are all signs that you may have a rotatorcuff injury. While those symptoms are also common in bursitis, Brady says people experiencing pain that lasts for more than three to four weeks and can’t be controlled with anti-inflammatory drugs such as Ibuprofen or Naproxen, should see a doctor.

“It would be nice if patients would seek treatment a little earlier because the literature is very clear – if you treat these things when the tear is early or when the tear is smaller, patients do better than if you wait a long time,” said Brady. “I guarantee you – if Mr. Avera had waited a long time, he would’ve not done well with arthroscopic surgery. He probably would’ve had to have a reverse shoulder replacement and even then, he wouldn’t have done as well as he did.”