Rotator cuff tears are one of the most common causes of shoulder pain, particularly in patients over 40 and in those who perform repetitive overhead activities or sports.
What is the Rotator Cuff?
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, keeping the head of the humerus centred in the socket while allowing a wide range of motion. A tear can occur in one or more of these tendons, ranging from a small partial-thickness fray to a large full-thickness tear.
Causes and Risk Factors
Rotator cuff tears may result from a single traumatic injury, such as a fall onto an outstretched arm, or from gradual wear and tear related to ageing, repetitive overhead motion, or reduced blood supply to the tendon. Risk increases with age, smoking, and occupations or sports involving repeated overhead use of the arm.
Symptoms
- Pain at the front or side of the shoulder, often worse at night
- Weakness when lifting or rotating the arm
- Difficulty reaching overhead or behind the back
- A crackling or catching sensation with certain movements
Diagnosis
Diagnosis usually begins with a clinical examination assessing strength, range of motion and specific shoulder tests, followed by imaging such as ultrasound or MRI to confirm the size and location of the tear and to help guide treatment planning.
Treatment Options
Not all rotator cuff tears require surgery. Initial management often includes activity modification, physiotherapy to strengthen the surrounding muscles, anti-inflammatory medication, and occasionally a corticosteroid injection to settle pain. Surgery, typically arthroscopic rotator cuff repair, is considered for larger tears, tears that fail to improve with non-surgical treatment, or in active patients seeking a return to sport or overhead work.
Recovery
Recovery from rotator cuff repair is gradual and typically follows a structured rehabilitation protocol over several months, progressing from protected motion to strengthening and finally a return to full activity. Please see our Rehabilitation Protocols section for general post-operative guidelines.
This article is intended for general information only and does not replace a personal consultation. If you are experiencing shoulder pain, please arrange an appointment for an individual assessment.