Rotator Cuff Tear
What is the rotator cuff?
The rotator cuff is a group of four muscles and tendons that surround the shoulder joint. These structures hold the ball of the upper arm bone (humerus) securely in the shallow shoulder socket, allowing for smooth and stable movement.
The rotator cuff helps lift, rotate, and stabilize the shoulder during everyday activities like reaching, lifting, or throwing. It keeps the shoulder joint centered and controls movement, making it essential for both strength and coordination.
A rotator cuff tear often causes shoulder pain, especially when lifting the arm, reaching overhead, or lying on the affected side. You might notice weakness, limited motion, and sometimes a crackling or clicking sound when moving your shoulder. Some patients will have difficulty sleeping on the affected shoulder.
Rotator cuff tears can result from sudden injuries, like falling on an outstretched arm, or develop gradually from overuse, especially with repetitive overhead activities. Aging and wear-and-tear also weaken the tendons, making tears more likely over time.
Diagnosis starts with a physical exam to check strength, motion, and pain patterns. Imaging tests like X-rays rule out bone problems, while an MRI shows the size and location of the tear and helps guide treatment.
Treatment depends on the size of the tear, symptoms, and your activity level. Small or partial tears are often treated with physical therapy, anti-inflammatory medication, and injections. Larger or painful tears that don’t improve may need surgery to restore shoulder strength and function.
No, not all tears require surgery. Many people manage small or partial tears successfully with physical therapy and lifestyle adjustments. Surgery is usually considered for larger full-thickness tears, persistent pain, weakness, or when shoulder function does not improve with non-surgical care.
Recovery typically takes up to 6 months, though full healing can take up to a year. Physical therapy starts with gentle motion and progresses to strength training. A sling is worn for several weeks to protect the repair during early healing.
At a Glance
Sachin Allahabadi, MD
- Board-Certified & Fellowship-Trained Sports Medicine Surgeon
- Expertise in Minimally Invasive Knee & Shoulder Surgeries
- Assistant Professor of Clinical Orthopaedic Surgery, Houston Methodist Hospital & Weill Cornell Medical College
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