A partial or complete rotator cuff tear makes it difficult to raise and move your arm. You may have shoulder pain and arm weakness. Rotator cuff injuries are common, especially as you get older. Rest, pain relievers and physical therapy can help. Some people need surgery to reattach a torn rotator cuff.
A rotator cuff tear is an injury to your rotator cuff that can cause shoulder pain and the inability to use your arm. Your rotator cuff is a group of muscles and tendons in your shoulder. They help you lift and move your arms away from your body. Your rotator cuff keeps the ball of your upper arm bone (humerus) in the shoulder blade socket.
Your shoulder is a ball-and-socket joint that’s part of your skeletal system. It’s like a golf ball sitting on a golf tee. Rotator cuff tears occur when tendons pull away from your arm bone. A tear may result from overuse or another injury.
Types of torn rotator cuffs include:
More than 2 million Americans experience some type of rotator cuff problem every year. Rotator cuff tears affect people of all ages, but the problem is more common in adults. In fact, it’s so common that there are people who have rotator cuff tears and don’t even know they have one because they have no symptoms.
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Rotator cuff tear symptoms include:
It depends. You may feel a dull ache deep within your shoulder, or it may feel like you’re being stabbed with a knife. Sudden tears from accidents or trauma cause immediate, intense shoulder pain and arm weakness. With degenerative tears, you may have mild pain that improves with over-the-counter (OTC) pain relievers. Over time, the pain gets worse, and pain relievers don’t help. Not everyone has pain, but most people have some degree of arm and shoulder weakness.
More commonly, rotator cuff tears occur over time as your tendon wears down with age and use (degenerative tear). People over age 40 are most at risk.
Causes of degenerative tears include:
Anyone can experience a rotator cuff tear. These factors may increase your risk:
Degenerative tears are more common among people who do the same repetitive shoulder movements, such as:
A rotator cuff tear can get worse without treatment. A complete tear can make it almost impossible to move your arm. Without treatment, you may have chronic shoulder pain and find it very difficult to use your injured arm.
Your healthcare provider will perform a physical exam to check for shoulder tenderness, range of motion and arm strength.
To confirm a diagnosis, you may get:
Rotator cuff tear treatment may include nonsurgical and surgical options.
Rotator cuff tears don’t heal on their own without surgery, but many people can improve functionally and decrease pain with nonsurgical treatment by strengthening their shoulder muscles. Just because you have a tear doesn’t necessarily mean you need surgery, as many people have rotator cuff tears and don’t even know it. About 8 out of 10 people with partial tears get better with nonsurgical treatments. It can take up to a year for the condition to improve.
Nonsurgical treatments include:
Your healthcare provider may recommend surgery if you have a complete tear or nonsurgical treatments don’t help a complete or partial tear. You may also have surgery if your job or athletic interests affect your shoulder.
Most rotator cuff surgeries take place arthroscopically through small cuts (incisions). Occasionally, the surgeon will use an open approach when needed. The surgery is an outpatient procedure. You go home the same day, but the overall recovery after this surgery is very substantial and can take up to a year or more.
During surgery, your healthcare provider:
For a partial tear, your healthcare provider may only need to trim fraying pieces of a partially torn tendon. This debridement procedure keeps your shoulder ball and socket from catching on your tendon and tearing it more.
Some tears aren’t repairable due to their size and/or the age of the tear. For these types of tears, you may need reverse shoulder replacement, tendon transfer or a debridement of scar tissue without repair.
After surgery, you need to wear a sling to immobilize your arm for four to six weeks. You can then start physical therapy. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12 to 18 months.
To prevent a symptomatic rotator cuff tear, it’s important to keep your muscles and tendons flexible. Your healthcare provider can teach you stretching and strengthening exercises to do at home.
Most people see improvements with nonsurgical treatments. Recovery takes time because your body needs time to heal. Most people who have surgery to repair a torn rotator cuff regain function.
It’s possible to tear the same tendon again, especially if the first tear was bigger than 1 inch. A re-tear that causes severe pain or loss of movement may require surgery.
You should call your healthcare provider if you experience:
You may want to ask your healthcare provider:
A note from Cleveland Clinic
If you work a very physical job or you’re an athlete, a rotator cuff injury will likely bench you, but it doesn’t have to be the end of your career. Talk to your healthcare provider about the best treatment options, whether nonsurgical or surgical. Your shoulder may be weak and painful for a while, but it’ll eventually heal.
Last reviewed by a Cleveland Clinic medical professional on 08/21/2023.
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