Rotator Cuff Tear
A rotator cuff tear is an injury to the group of muscles and tendons that surround the shoulder joint and help lift and rotate the arm. Tears may result from a sudden injury or gradual wear with age. They commonly cause shoulder pain, weakness and difficulty with overhead movements.
Overview
What is a rotator cuff tear?
The rotator cuff is a group of muscles and tendons that surround the shoulder joint, holding the upper arm bone in place and allowing you to lift and rotate your arm. A rotator cuff tear is when one or more of these tendons is partly or completely torn. This can reduce the shoulder's strength and range of movement.
How common is a rotator cuff tear and who does it affect?
Rotator cuff problems are a very common cause of shoulder pain, and tears become more frequent with age as the tendons gradually weaken. They often affect middle-aged and older adults. People who do repetitive overhead activities, whether through work or sport, are also more likely to develop a tear. Sudden injuries can affect any age.
Symptoms and Causes
What are the symptoms of a rotator cuff tear?
Common symptoms include shoulder pain, which may be worse at night or when lifting the arm, and weakness when raising or rotating the arm. Some people notice difficulty reaching overhead or behind their back, or a crackling sensation with movement. A sudden tear from injury may cause immediate intense pain, while gradual tears often build up slowly.
What causes a rotator cuff tear and who is at risk?
Tears can happen suddenly, for example after a fall or lifting something heavy, or develop gradually as tendons wear and weaken with age. Risk factors include older age, repetitive overhead movements in work or sport, previous shoulder injury and certain physically demanding jobs. Smoking and a family tendency to tendon problems may also play a role.
Diagnosis and Tests
How is a rotator cuff tear diagnosed?
A doctor usually assesses the shoulder by asking about your symptoms and examining its movement and strength with specific tests. Imaging may be used to confirm a tear and judge its size. Ultrasound and MRI scans are particularly helpful for showing the tendons, while X-rays can rule out other causes such as bone or joint problems.
Management and Treatment
How is a rotator cuff tear treated or managed?
Many rotator cuff tears improve with non-surgical care, including rest from aggravating activities, physiotherapy to restore strength and movement, and pain-relieving measures. Some people benefit from injections. When a tear is large, caused by a sudden injury, or does not improve with these measures, a specialist may discuss surgery to repair the tendon.
Prevention
Can a rotator cuff tear be prevented or its risk reduced?
Not all tears can be prevented, especially those linked to ageing or accidents. However, keeping the shoulder muscles strong and flexible, using good technique during sport and lifting, avoiding sudden overloading and taking regular breaks from repetitive overhead tasks may help. Warming up before activity and not smoking can also support healthy tendons.
Additional Common Questions
Can a rotator cuff tear heal on its own?
A torn tendon does not usually rejoin by itself, but symptoms often improve with rest and physiotherapy. Many people regain good function without surgery, depending on the size and cause of the tear.
Should I keep my shoulder completely still after a tear?
Usually not. While painful activities should be limited, gentle guided movement and physiotherapy are important to prevent stiffness and restore function. Your specialist will advise what is safe for you.
Will I definitely need surgery?
Not necessarily. Many tears are managed without surgery. An operation is more likely to be considered for large tears, sudden injuries, or symptoms that do not improve with other care.
Sources
This health topic is for general information and is not a substitute for professional medical advice. Always consult a qualified clinician about your individual situation. See our medical disclaimer.