Shoulder Care
Rotator cuff tears: symptoms and treatment.
A rotator cuff tear can cause shoulder pain, weakness, and difficulty reaching or lifting. Treatment is individualized according to how the tear occurred, its size and pattern, your symptoms, and the activities you want to return to.
When to schedule an evaluation
- Shoulder pain that persists or interrupts sleep
- Weakness when raising or rotating the arm
- Difficulty with work, sports, or everyday activities
- Sudden pain or weakness after a fall or other injury
- Symptoms that have not improved with rest or therapy
Understanding the Injury
What is the rotator cuff?
The rotator cuff is a group of four tendons that surrounds the shoulder joint. These tendons help lift and rotate the arm while keeping the ball of the shoulder centered in its socket.
A tear may develop gradually as the tendon changes over time or occur suddenly during a fall, forceful lift, collision, or other injury. Tears can involve part of the tendon thickness or extend through the full thickness of the tendon.
Common Symptoms
How a rotator cuff tear may feel.
Pain
Pain may occur along the side or front of the shoulder and can worsen with reaching, lifting, or sleeping on the affected side.
Weakness
The arm may feel weak when lifting overhead, reaching away from the body, or rotating the shoulder.
Loss of function
Daily activities such as dressing, washing your hair, working overhead, or participating in sports may become difficult.
Evaluation
Evaluation begins with a discussion of your symptoms, the way the problem started, and your activity goals. The examination typically assesses shoulder motion, strength, tenderness, and function.
X-rays can identify arthritis, bone spurs, or other bony changes. Ultrasound or MRI may be recommended to evaluate the rotator cuff tendons and surrounding structures.
Nonsurgical treatment
Many rotator cuff tears can initially be managed without surgery. Depending on the situation, treatment may include activity modification, anti-inflammatory medication when medically appropriate, physical therapy, and an injection.
The goal is to reduce pain, restore useful motion and strength, and help you return safely to important activities.
Surgical Care
When rotator cuff repair may be considered.
Surgery may be discussed when pain or weakness continues despite appropriate nonsurgical care, when the tear substantially limits function, or when a repairable tear occurs after an acute injury. Age, overall health, tear size, tendon quality, activity demands, and personal goals all contribute to the decision.
Most repairs are performed arthroscopically through small incisions. The torn tendon is reattached to the bone so it can heal. Additional problems involving the biceps tendon, labrum, or surrounding tissue may be treated during the same procedure when appropriate.
Recovery
Rehabilitation is part of the repair.
Recovery is gradual because the tendon needs time to heal securely to the bone. A sling is commonly used early, followed by a staged physical therapy program that progresses from protected motion to strengthening.
The timing of driving, work, lifting, and sports varies with the tear, the repair, and the demands of each activity. Progress is based on healing, motion, strength, and safe function rather than a single timetable.
View the rotator cuff repair animation →Frequently Asked Questions
Common questions about rotator cuff tears.
Does every tear require surgery?
No. Many people improve with nonsurgical treatment. Surgery is considered according to the type of tear, severity of symptoms, functional loss, response to treatment, and individual goals.
Can a tear get larger?
Some tears remain stable, while others may enlarge over time. Ongoing pain, increasing weakness, or loss of function should be reassessed.
Will I need an MRI?
Not everyone needs advanced imaging immediately. MRI or ultrasound may be recommended when the examination suggests a tear or when the result would affect treatment planning.
How long does recovery take?
Recovery varies. Tendon healing and rehabilitation take months, and return to demanding work or sports generally occurs later than return to basic daily activities.
Additional Patient Education
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Medical review: Michael C. Stanton, M.D. · September 2026
This information is for general educational purposes and does not replace an evaluation or individualized medical advice.