Rotator Cuff Tear
What Is a Rotator Cuff Tear?
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, holding the ball of the humerus centered in its socket while allowing the wide range of motion the shoulder is known for. A rotator cuff tear occurs when one or more of these tendons is partially or completely torn away from the bone, most often affecting the supraspinatus tendon at the top of the shoulder.
What Causes a Rotator Cuff Tear?
Rotator cuff tears generally fall into two categories:
- Acute (traumatic) tears — caused by a specific injury, such as a fall onto an outstretched arm, a sudden heavy lifting motion, or a shoulder dislocation
- Degenerative tears — develop gradually over time as tendons naturally weaken with age, repetitive overhead use, or reduced blood flow to the tendon as we get older; these tears can worsen slowly and sometimes go unnoticed until they become large
Risk factors include advancing age, repetitive overhead activity (common in painters, carpenters, and overhead athletes), smoking, and a family history of rotator cuff problems.
What Are the Symptoms of a Rotator Cuff Tear?
- Pain, often described as a deep ache in the shoulder, frequently worse at night
- Weakness when lifting the arm or reaching overhead
- Difficulty reaching behind the back
- A crackling or popping sensation with shoulder movement
- In sudden, traumatic tears, an immediate snap or pop followed by significant weakness
Can You Still Move Your Arm With a Torn Rotator Cuff?
Often, yes — many patients with a rotator cuff tear retain some ability to raise the arm, particularly with partial tears or when other shoulder muscles compensate for the damaged tendon. However, a large or complete tear frequently causes noticeable weakness, especially when trying to lift the arm out to the side or overhead against resistance. Some patients with a large, long-standing tear may be unable to raise the arm above shoulder height at all — a finding your provider will specifically test for during an exam.
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Treatment Options for a Rotator Cuff Tear
Nonsurgical treatment may be effective for smaller, partial tears, especially in older or less active patients:
- Physical therapy to strengthen the surrounding shoulder muscles and improve mechanics
- Anti-inflammatory medication
- Activity modification
- Corticosteroid injections for symptom relief
Surgery is often recommended for larger or full-thickness tears, tears in younger or more active patients, acute traumatic tears, and tears that continue to cause pain or weakness despite nonsurgical treatment. Rotator cuff repair reattaches the torn tendon back to the bone, most often performed arthroscopically. Learn more on our Rotator Cuff Surgery page.
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Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.