Rotator Cuff Tears (shoulder)

What is it?

A rotator cuff tear is a tear in one or more of the four tendons that help stabilise the shoulder and move the arm. Tears can be partial or complete (full-thickness).

Who is at risk?
  • Adults over 40, especially over 60
  • People in overhead professions or sports
  • Those with a history of shoulder injuries
  • Smokers (healing is slower)
  • Individuals with poor shoulder posture or mechanics
What are some common symptoms?
  • Shoulder pain, especially at night or when lifting the arm
  • Weakness in the shoulder
  • Limited range of motion
  • Clicking or popping sounds with movement
  • Difficulty performing overhead activities
Causes?
  • Acute injury (e.g., fall, lifting something too heavy)
  • Degenerative wear and tear (common with age)
  • Repetitive overhead activity (e.g., painting, swimming, tennis)
  • Poor posture or bone spurs rubbing on the tendon
How is it diagnosed?
  • Physical exam (testing strength and motion)
  • Imaging tests:
    • MRI (best for showing soft tissue tears)
    • Ultrasound (can also show tendon damage)
    • X-rays (to rule out arthritis or bone spurs)
Can it heal on its own?
  • Partial tears may improve with rest and rehab
  • Complete tears usually do not heal on their own, but symptoms may become manageable without surgery
How long will recovery take?
  • Non-surgical rehab: 2–4 months
  • Surgical repair:
  • Immobilisation (sling): ~4–6 weeks
  • Physical therapy: starts early but continues 3–6 months
  • Full recovery: 6–12 months, depending on tear size and adherence to rehab
What does treatment look like?

 Non-surgical:

  • Rest and activity modification
  • NSAIDs (e.g., ibuprofen)
  • Physical therapy to strengthen surrounding muscles
  • Corticosteroid injections for inflammation

Surgical (if needed):

  • Arthroscopic rotator cuff repair
  • Open surgery for larger or complex tears
  • Surgery is typically not needed, best to consult an orthopaedic surgeon first
How can I prevent this?
  • Strengthen shoulder and upper back muscles
  • Avoid repetitive overhead lifting
  • Use proper lifting technique
  • Stretch regularly, especially before sports or heavy work
  • Take breaks during repetitive tasks
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