What is a rotator cuff tear?
The rotator cuff is a group of four muscles and their tendons that surround your shoulder joint. Together, they help keep the shoulder stable while allowing you to lift, reach and rotate your arm.
A rotator cuff tear occurs when one of these tendons is damaged. The most commonly affected tendon is the supraspinatus, which helps lift your arm. Tears can happen suddenly after an injury or develop gradually over time as the tendon naturally weakens with age.
Rotator cuff tears are a common cause of shoulder pain and are often seen in people who play throwing or racquet sports, as well as in older adults.
What are the symptoms?
Not everyone with a rotator cuff tear experiences pain. In fact, some people have a tear without even knowing it.
When symptoms are present, they may include:
- Pain when lifting your arm or reaching overhead
- Weakness in the shoulder
- Reduced range of movement
- Pain that travels down the upper arm
- Difficulty sleeping, especially when lying on the affected side
Interestingly, the amount of pain doesn’t always match the size of the tear. Some small tears can be very painful, while larger tears may cause very few symptoms.
What causes a rotator cuff tear?
Rotator cuff tears can occur after a sudden injury, such as:
- Falling onto an outstretched hand
- Lifting something heavy unexpectedly
- A sudden twisting or overstretching movement
However, most tears develop gradually over time. As we age, tendons naturally become less flexible and more prone to wear and tear. Repetitive overhead activities, heavy lifting and poor shoulder mechanics can also place extra stress on the tendons, increasing the risk of injury.
How can physiotherapy help?
Physiotherapy is often the first line of treatment for rotator cuff tears. Your physiotherapist will assess your shoulder and develop a personalised treatment plan to help you:
- Reduce pain
- Restore shoulder movement
- Improve strength
- Return to work, sport and everyday activities
Treatment may include targeted exercises, hands-on therapy, advice on activity modification and education to support your recovery.
While surgery is sometimes recommended, research has shown that many people—including those with some larger age-related tears—can achieve excellent results with a structured rehabilitation program alone.
Recovery varies from person to person and depends on factors such as the severity of the tear, your general health, activity levels and whether surgery is required.
Remember: Shoulder pain shouldn’t be ignored. Early assessment and treatment can help improve recovery and get you back to doing the things you enjoy.
The information in this newsletter is intended for general education and is not a substitute for individual medical advice. If you have shoulder pain or think you may have a rotator cuff injury, speak with your physiotherapist or healthcare professional for an assessment.