Rotator Cuff Injury & Tear: Causes, Diagnosis & Treatment
Rotator cuff injuries can cause shoulder pain, weakness, and limited mobility. Dr Foo offers precise diagnosis and customised treatment to restore shoulder function and ease discomfort.
MBBS (University of London) | MMed (Ortho) | FRCSEd (Ortho) | FAMS (Ortho)
What Is a Rotator Cuff Injury?
A rotator cuff injury occurs when one or more of the muscles and tendons stabilising
the shoulder joint become strained, inflamed, or torn. These injuries can range
from mild inflammation (tendinitis) to partial or complete tendon tears, affecting shoulder
movement and strength.
The rotator cuff comprises four muscles and their tendons, which secure the humerus (upper
arm bone) within the shallow shoulder socket. Damage to these structures can significantly
impair daily activities, making it difficult to lift objects, reach overhead, or even
perform routine tasks like dressing or sleeping comfortably.
If left untreated, they can lead to chronic shoulder dysfunction and long-term
weakness.
What Causes a Rotator Cuff Tear or Injury?
Rotator cuff injuries are commonly caused by repetitive strain, age-related degeneration, trauma, or structural abnormalities in the shoulder.
- Age-Related Degeneration – Reduced blood supply, collagen breakdown, and repeated microtears progressively weaken the tendons, increasing the risk of injury.
- Repetitive Overhead Activities – Frequent overhead motions, such as lifting, throwing, swimming, or painting, place continuous stress on the tendons, leading to inflammation and potential tearing over time.
- Acute Injury – A sudden fall, direct impact, or forceful arm movement can overstretch or tear the rotator cuff tendons, often resulting in immediate pain and loss of function.
- Poor Posture and Biomechanics – Forward-rounded shoulders, muscle imbalances, or improper movement patterns place excessive strain on the rotator cuff, increasing the risk of degeneration and tearing.
- Bone Spurs (Shoulder Impingement Syndrome) – Bony overgrowths on the acromion (shoulder blade) can press on the rotator cuff tendons, causing irritation, inflammation, and potential tearing over time.
Symptoms of a Rotator Cuff Injury
Rotator cuff injuries often cause shoulder pain, weakness, and reduced mobility, which can
progressively worsen without treatment.
Common symptoms include:
- Persistent shoulder pain, especially when reaching overhead, lifting objects, or lying on the affected side at night.
- Shoulder weakness, particularly when lifting or rotating the arm, making tasks like reaching overhead, carrying objects, or even combing hair difficult.
- Restricted range of motion, making it hard to raise the arm, reach behind the back, or perform everyday activities.
- Swelling and tenderness around the front and side of the shoulder, sometimes accompanied by stiffness.
- Clicking, cracking, or popping sounds when moving the shoulder joint, which may indicate tendon involvement.
If left untreated, a rotator cuff injury can worsen over time, leading to chronic pain, reduced mobility, and difficulty performing daily activities. If you are experiencing persistent shoulder pain, weakness, or limited movement, consult a shoulder specialist for a proper evaluation and a personalised treatment plan. Rotator Cuff Tear & Injury Diagnosis
A rotator cuff injury is typically diagnosed through a combination of medical history review, physical examination, and imaging tests.
- Medical History Review – A review of your symptoms, previous injuries, and daily activities that may contribute to shoulder pain.
- Physical Examination – A physical assessment of your shoulder strength, range of motion, and pain triggers through specific movement tests to identify possible tendon involvement.
-
Imaging Tests
- X-rays – While X-rays do not show soft tissue injuries, they can identify bone spurs or other structural abnormalities contributing to shoulder pain.
- Ultrasound or MRI Scans – These imaging techniques provide detailed views of soft tissues, helping detect tendon inflammation, tears, or degeneration.
Rotator Cuff Injury Treatment
Treatment for rotator cuff injuries ranges from conservative management to surgical intervention, depending on the severity and cause of the injury.
| Treatment Approach | Description & Purpose |
|---|---|
| Non-Surgical Management | |
| Rest and Activity Modification | Avoiding movements and activities that worsen pain allows the shoulder to heal and prevents further strain on the rotator cuff. |
| Pain and Inflammation Management | Pain medications and non-steroidal anti-inflammatory drugs (NSAIDs) help manage discomfort and reduce swelling. Icing can also help minimise acute inflammation, while heat therapy alleviates muscle stiffness and enhances circulation. |
| Physiotherapy and Rehabilitation Exercises | Structured, targeted exercises strengthen rotator cuff muscles, improve flexibility, and enhance shoulder stability, aiding recovery and preventing further injury. |
| Injection-Based Treatment | Includes corticosteroid injections for temporary pain relief and inflammation reduction in the rotator cuff, though repeated use may weaken tendons over time. Hyaluronic acid injections help improve joint lubrication and reduce discomfort in cases of associated shoulder degeneration. Platelet-Rich Plasma (PRP) therapy uses a patient’s own platelets to help promote tendon healing and reduce inflammation. |
| Surgical Intervention | |
| Shoulder Arthroscopy | A minimally invasive procedure involving a small incision and the use of a camera to guide the reattachment of the torn tendon to the bone with sutures. |
| Open Tendon Repair | A traditional surgical method involving a larger incision to access and repair the damaged tendon, typically used for more extensive tears. |
| Shoulder Replacement Surgery (Arthroplasty) | In cases of severe tendon damage and joint degeneration, the shoulder joint is replaced with an artificial implant to restore function and relieve pain. |
Rotator Cuff Injury & Tear Recovery
Recovery time for rotator cuff injuries depends on injury severity, treatment approach, and individual healing response.
- Mild to moderate injuries (e.g., tendinitis or small tears) may heal within 4 to 12 weeks with conservative management.
-
Post-surgical recovery:
- Shoulder Arthroscopy – Recovery generally takes 4 to 6 months, as this minimally invasive procedure allows for faster healing, with full strength and function typically regained in 9 to 12 months through physiotherapy.
- Open Repair – Requires 6 to 9 months due to the larger incision and more extensive tendon reattachment, leading to a longer healing process.
- Shoulder Replacement – Full recovery may take 6 to 12 months, as joint reconstruction and muscle adaptation require extended rehabilitation, depending on the severity of joint damage and post-surgical recovery progress.
Can a Rotator Cuff Injury Be Prevented?
While some risk factors are unavoidable, several strategies can reduce the likelihood of a rotator cuff injury:
- Strengthening Shoulder Muscles – Targeted exercises to strengthen the rotator cuff muscles (supraspinatus, infraspinatus) and scapular stabilisers improve shoulder stability and reduce strain.
- Maintaining Good Posture – Keeping the shoulders aligned and avoiding slouching minimises unnecessary stress on the rotator cuff.
- Gradual Progression in Physical Activities – Increasing exercise intensity or lifting too quickly can overload the shoulder; gradual progression allows muscles and tendons to adapt safely.
- Using Proper Technique – Maintaining correct biomechanics in repetitive or overhead movements prevents excessive shoulder stress and reduces injury risk.
When Should You Seek Medical Attention?
You should seek medical attention if you suspect a rotator cuff injury or if you experience:
- Persistent or worsening shoulder pain lasting more than a few weeks despite rest and home treatment.
- Significant weakness or loss of function in the affected arm, making it difficult to lift objects or perform daily activities.
- Pain that disrupts sleep, especially when lying on the affected side.
- A sudden injury causing intense pain, swelling, or an inability to move the shoulder.
- Clicking or popping sounds accompanied by pain or instability in the shoulder joint.
Every patient deserves a treatment plan tailored to their needs. We start with non-surgical approaches before considering more invasive interventions.
Dr Foo Gen Lin
Find a Shoulder Specialist Near Me
Apex Novena
admin@apexsportsclinic.sg
101 Irrawaddy Rd, #18-12 Royal Square Medical Centre, Singapore 329565
Nearest MRT: NS20 Novena
Apex East Coast
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112 E Coast Rd, #03-03/04 i12 Katong, Singapore 428802
Nearest MRT: TE26 Marine Parade
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