Rotator Cuff Tear

Pain — on the outer shoulder, often worse at night and when lying on that side. Weakness — lifting or rotating the arm, especially overhead. Difficulty with overhead tasks — — reaching a shelf, brushing hair, dressing. A crackling sensation — when moving the shoulder in certain positions. Loss of strength — that can make the arm feel unreliable.

Age-related tendon degeneration (most common over 50). Repetitive overhead activity — painting, construction, certain sports. A single traumatic injury, such as a fall onto the arm. Reduced blood supply to the tendon with age. Bony spurs that rub and fray the tendon over time.

Examination tests the strength and range of each cuff muscle to localise the problem. Ultrasound and MRI both visualise the tendons — confirming whether a tear is partial or full-thickness, its size, and the quality of the muscle, all of which guide treatment.

Many tears — particularly partial and degenerative ones — are managed successfully without surgery. The decision balances tear size, your age, activity and how much the shoulder limits you. Physiotherapy: A structured programme strengthens the surrounding muscles to compensate and reduce pain — effective for many partial tears. Arthroscopic repair: The torn tendon is reattached to the bone through keyhole incisions, restoring strength for larger or full-thickness tears.

After a repair, the shoulder is protected in a sling while the tendon heals to the bone — this early protection is essential. A staged programme then rebuilds motion and strength over three to six months. Most patients regain comfortable, functional shoulders and return to the activities that matter to them.