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. These structures work together to stabilize the shoulder and allow for controlled lifting, rotating, and reaching motions. A rotator cuff tear refers to a disruption in one or more of these tendons, either from injury or degeneration. The tear may be partial (where the tendon is damaged but not fully severed) or full-thickness (where the tendon is completely torn).
Tears are most commonly seen in the supraspinatus tendon, though any of the four tendons (supraspinatus, infraspinatus, subscapularis, teres minor) can be affected.
Causes and Risk Factors
Rotator cuff tears can result from:
Acute injury (e.g., lifting something heavy, falling on an outstretched arm)
Repetitive overhead activity (common in athletes and laborers)
Degenerative wear and tear over time, especially in people over age 40
Additional risk factors include:
Smoking
Poor posture or scapular mechanics
Weak shoulder stabilizer muscles
Family history of rotator cuff problems
Symptoms
Pain in the shoulder, especially at night or when lying on the affected side
Weakness with overhead movements or lifting
Limited range of motion
Clicking or cracking sensation during motion
Difficulty reaching behind the back
In more severe cases, inability to lift the arm without assistance
Diagnosis
Physical examination with strength and motion testing
X-rays to assess bone alignment and rule out arthritis
MRI or ultrasound to visualize the extent and location of the tendon tear
Special tests (e.g., Drop Arm Test, Empty Can Test) performed during exam
Treatment
Non-Surgical Treatment
Activity modification to avoid aggravating movements
NSAIDs to reduce inflammation and pain
Physical therapy to strengthen surrounding muscles and improve shoulder mechanics
Corticosteroid injections may be considered for temporary pain relief
Many partial tears and degenerative full-thickness tears can be managed successfully without surgery, especially in older or less active individuals.
Surgical Treatment
Recommended for:
Acute full-thickness tears in younger or active patients
Tears causing significant weakness or loss of function
Failure of conservative treatment over 3–6 months
Arthroscopic rotator cuff repair:
Minimally invasive
Uses sutures and anchors to reattach torn tendons
In some cases, tendon transfers or shoulder replacement may be necessary for massive, irreparable tears
Recovery Outlook
Non-surgical recovery may take 3 to 6 months with structured rehab
Post-surgical recovery:
Sling immobilization for several weeks
Physical therapy begins soon after to restore range of motion
Strengthening starts after healing phase
Full return to activity typically takes 4 to 6 months, depending on the severity of the tear and healing response
Why Kerlan Jobe Institute?
The shoulder specialists at Kerlan Jobe Institute are nationally recognized for their expertise in rotator cuff repair and rehabilitation. Whether through conservative management or advanced arthroscopic surgery, our team provides personalized care to help each patient regain strength, motion, and confidence in their shoulder.