Being told you have a rotator cuff tear can be worrying. Many people assume a tear means surgery. In reality, many rotator cuff tears are managed very successfully with a structured rehabilitation program. The key is working out which type of tear you have.
What is the rotator cuff?
The rotator cuff is a group of four muscles and their tendons that wrap around the shoulder joint. They keep the ball of the shoulder centred in its socket and help you lift and rotate your arm. Because the shoulder is so mobile, these tendons work hard every day.
Two very different types of tear
Degenerative tears develop gradually as tendons change with age. They are very common: studies show many people over 60 have rotator cuff tears on scans without any shoulder pain at all. When these tears do cause pain, exercise-based rehabilitation is usually the first and most effective treatment, and research shows outcomes are often similar to surgery for many people.
Traumatic tears happen with a specific injury, such as a fall onto an outstretched arm, a dislocation, or trying to catch something heavy. If you suddenly cannot lift your arm after an injury, it is important to be assessed quickly. Some acute tears, particularly in younger and active people, do best with early surgical repair, ideally within a few weeks.
Common symptoms
- Pain on the outside of the shoulder or upper arm
- Pain lifting your arm, reaching overhead or behind your back
- Pain lying on the affected side at night
- Weakness, especially when lifting or rotating the arm
How physiotherapy helps
Your assessment will look at your strength, movement and the history of your symptoms to work out the likely type of tear and the best path forward. Rehabilitation typically includes:
- Pain management and activity advice so you can keep using your arm
- Progressive strengthening of the rotator cuff and shoulder blade muscles
- Restoring movement through targeted mobility exercises
- Return to work, sport and daily tasks with a graded plan
If your shoulder is not improving as expected, or if your tear needs a surgical opinion, we will refer you to your GP or an orthopaedic surgeon and work closely with them. If you do have surgery, we also guide your post-operative rehabilitation from day one.
Shoulder pain stopping you from doing what you love? Book an appointment today. Learn more about shoulder pain treatment.
Information on this page is general and does not replace individual medical or physiotherapy advice. Your clinician will explain the most appropriate options after assessing you.
