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Rotator Cuff Tear

Overview

A rotator cuff tear (RCT) refers to the tear of the rotator cuff muscles; the rotator cuff comprises four muscles surrounding the shoulder joint that arise from the shoulder blade (scapula). These muscles may tear partially or completely depending on the underlying cause. RCTs are common and are more likely to occur with age or overuse of the shoulder joint.

The common types of RCTs are:

  • Partial tear, where the tendon is damaged but not completely severed.
  • Complete tear, where the tendon fully detaches from the bone.

Common symptoms of a rotator cuff tear include:

  • Shoulder pain, especially when the patient lifts the arm or lies down on the affected side.
  • Weakness in the shoulder, making it hard to lift or rotate the arm.
  • Stiffness and difficulty in performing daily activities.
  • Clicking or crackling sounds when moving the shoulder.

Rotator cuff tears can occur due to different reasons:

  • Age above 40 years increases the likelihood of wear and tear.
  • Trauma from injuries, such as falls or accidents, or degeneration from age-related changes.
  • Smoking, which reduces blood flow and weakens tendon health.
  • Overuse of the shoulder
  • Orthopaedic sports injuries from weightlifting or overhead sports such as tennis or baseball.

Diagnosis combines a patient’s history, symptoms, and imaging tests:

  • Doctors first consider history (injury or non-injury), symptoms (such as pain or weakness that affect daily activities), and clinical tests performed by a shoulder specialist.
  • The diagnosis is further confirmed by performing ultrasonography or magnetic resonance imaging.

Depending on the age and overall condition of the patients, how active they are, and the type and size of the tear, the following treatment methods are recommended:

  • Conservative management includes rest, non-steroidal anti-inflammatory medicines, physical therapy (targeting specific muscles), or even steroid injections (primarily advised for pain management).
  • Surgical options include a rotator cuff repair (arthroscopic or open), muscle transfers (in patients with massive irreparable tears), or even joint replacement surgery (reverse shoulder replacement).

Seek medical attention if:

  • Shoulder pain persists despite rest and simple medicines.
  • Weakness in the arm prevents you from lifting objects or performing daily tasks.
  • You experience sudden pain after an injury or accident.
  • Symptoms worsen over time and affect sleep or quality of life.

Preventive measures can lower the risk of developing rotator cuff tears:

  • Maintain good posture to reduce shoulder strain.
  • Strengthen shoulder and back muscles with regular exercise.
  • Avoid smoking to protect tendon health.
  • Take breaks and use correct techniques when doing repetitive overhead movements or heavy lifting.

Patients suspected to have or diagnosed with an RCT are advised to consult with

  • A general physician for initial evaluation and pain management.
  • An orthopaedic surgeon or shoulder specialist for advanced care and surgical advice.
  • A physiotherapist for guided rehabilitation and strengthening exercises.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.