Rotator Cuff Tears

Rotator cuff tears are among the most common causes of shoulder pain, especially in adults who perform repetitive overhead movements or those experiencing age-related tendon changes. Whether your tear is new, old, or previously undiagnosed, early assessment and targeted physiotherapy can significantly improve pain, strength, and day-to-day function.

The rotator cuff is a group of four important muscles and their tendons that surround the shoulder joint. These include:

• Supraspinatus
• Infraspinatus
• Teres Minor
• Subscapularis

Together, they provide stability, allow smooth shoulder rotation, and support overhead movements.

A rotator cuff tear occurs when one or more of these tendons become overstretched or damaged. Tears may be:

• Partial (incomplete) – tendon is damaged but not fully severed
• Full-thickness – tendon completely separates from the bone
• Acute or traumatic – sudden injury from a fall or force
• Chronic or degenerative – occurring gradually from wear and tear

Rotator cuff tears are especially common in:

• Racket sports
• Trades requiring heavy lifting
• Overhead work
• Throwing sports
• People over the age of 40 due to natural tendon degeneration

Some individuals have rotator cuff tears without any symptoms, while others experience significant discomfort. Typical signs include:

• Shoulder pain, particularly when lifting or reaching overhead
• Pain radiating down the arm
• Weakness when lifting objects or rotating the arm
• Reduced shoulder range of movement
• Night pain, especially when lying on the affected shoulder
• Difficulty performing daily tasks like dressing, reaching, or lifting

Interestingly, tear size does not always match pain levels-small tears can be very painful, while some large tears may go unnoticed.

Rotator cuff tears can occur due to a single traumatic event or from gradual degeneration over time. Common causes include:

1. Traumatic Injury

• Falling onto an outstretched arm
• Sudden pulling movement
• Heavy lifting with a jerking motion
• Rapid twisting of the shoulder

2. Degenerative or Overuse Causes

• Age-related wear and tear
• Reduced blood supply to the tendon
• Poor shoulder biomechanics
• Repetitive overhead activities (painting, construction, sports)
• Long-term shoulder weakness leading to overload

Over time, these factors reduce tendon strength and elasticity, increasing the chances of a tear.

A thorough assessment typically includes:

• Clinical examination
• Range of motion and strength tests
• Imaging if required – ultrasound or MRI
  
• Discussion of symptoms and history
  

Physiotherapy is often the first and most effective line of treatment. Research shows that many rotator cuff tears-even large ones-can be successfully managed without surgery when supported by a structured rehabilitation program.

Your physiotherapy treatment may include:

• Pain management strategies
• Manual therapy to improve joint mobility
• Targeted strengthening for the rotator cuff and surrounding muscles
• Posture and shoulder mechanics correction
• Activity modification to reduce irritation
• Progressive rehabilitation plan tailored to your goals

Surgery may be recommended for severe or non-responding tears, but evidence shows conservative treatment can deliver similar functional outcomes in many cases.

Recovery time varies depending on:

• Injury severity
• Whether surgery is required
• Age
• Current shoulder strength and mobility

• Experienced Shoulder Physiotherapists specialising in complex tears
• Evidence-based rehabilitation programs tailored to your goals
• Holistic assessment addressing posture, biomechanics, and lifestyle factors
• Modern treatment techniques to reduce pain and improve mobility
• Friendly, patient-centred care focused on long-term recovery

Rotator cuff tears can be painful and limiting, but with early assessment, targeted strengthening, and professional guidance, most people regain strength and function without surgery.

For all your rotator cuff concerns, feel free to call us at 02 9793 8840 or Book an Appointment Today.