Rotator Cuff Tear
A plain-language overview of rotator cuff tear.
- Where
- Shoulder (tendon)
- Common signs
- Night pain, weakness overhead
- Options
- Therapy, injection, or rotator cuff repair
- Urgent?
- Severe pain, deformity, fever, or numbness: seek care promptly.
Overview
The rotator cuff is a group of four muscles and their tendons that keep the ball of the upper arm centered in the shoulder socket and help you lift and rotate your arm. A tear of one or more of these tendons is a common cause of shoulder pain and weakness.
Adapted from AAOS OrthoInfo, the patient education site of the American Academy of Orthopaedic Surgeons, and rewritten in plain language.
Anatomy
The shoulder is a ball-and-socket joint. The rotator cuff tendons cover the head of the upper arm bone (humerus) and attach it to the shoulder blade. A lubricating sac (bursa) sits between the cuff and the bone above it.
Causes
- A fall on an outstretched arm or lifting something too heavy (acute tear)
- Gradual wear of the tendon over time, which becomes more common with age
- Repetitive overhead activity in sports or work
- Bone spurs and reduced blood supply to the tendon
Symptoms
- Pain at rest and at night, especially lying on the affected side
- Pain when lifting or lowering the arm
- Weakness when lifting or rotating the arm
- Crackling with certain movements
Doctor exam & imaging
Your doctor will test strength and motion and look for other causes such as arthritis or neck problems. X-rays show bone spurs and arthritis; an MRI or ultrasound shows the tendon tear and its size.
Treatment
Nonsurgical treatment
Many people improve with rest, activity changes, anti-inflammatory medicine, physical therapy to strengthen the remaining muscles, and sometimes a steroid injection.
Surgical treatment
Surgery may be recommended for ongoing pain or weakness, larger tears, tears from an acute injury, or in active people who rely on overhead strength. Most repairs are done arthroscopically, reattaching the tendon to the bone with anchors and sutures. For large tears that cannot be repaired, other options may be discussed.
Recovery & return to activity
After repair, the arm is usually protected in a sling for several weeks, followed by gradual motion and then strengthening. Full recovery often takes several months.
When to seek care
- Sudden weakness after an injury or fall
- You cannot lift your arm
- Pain keeps you from sleeping or does not improve with home care
In an emergency, call 911.