Signs of a Rotator Cuff Tear
Where the shoulder hurts, when it hurts, and which motions are weak help point toward the rotator cuff.
Pain down the upper arm
An ache over the outside of the shoulder that can travel toward the elbow, worse with reaching.
Trouble sleeping on the shoulder
Pain that wakes you or makes it hard to lie on the affected side.
Difficulty lifting the arm
Weakness or fatigue raising the arm overhead or reaching behind the back.
A sudden loss of strength
A fall or lifting injury followed by new weakness can signal an acute tear, sometimes after a dislocation.
Not Every Rotator Cuff Tear Is the Same
Tear size, cause, and the quality of the tendon guide whether a tear is treated with therapy or repaired.
Tears that do not go all the way through the tendon, commonly treated with therapy first.
Treatment options →Tear DepthFull-Thickness TearsTears through the full tendon do not heal on their own, although symptoms may still improve with therapy.
Rotator cuff repair →CauseAcute Injury TearsA tear after a fall or lifting injury, which may be evaluated for earlier repair.
Rotator cuff repair →CauseDegenerative TearsTears that develop gradually with age and use.
Treatment options →ArthroplastyCuff Tear ArthropathyArthritis after a long-standing large tear, sometimes treated with reverse shoulder replacement.
Shoulder replacement →Shoulder PainOther Causes of Shoulder PainInstability, biceps problems, and arthritis can cause similar symptoms.
Shoulder pain guide →A Measured, Conservative-First Approach
Many rotator cuff tears improve without surgery. Repair is recommended based on the tear, your symptoms, and your goals.
Accurate Diagnosis
Rotator cuff strength testing, range of motion, and scapular mechanics, with the neck considered when relevant.
Nonoperative Care First
Physical therapy focused on rotator cuff and scapular strength, activity modification, and injections when indicated.
Surgery When Indicated
Arthroscopic repair is considered for many acute tears and for tears that stay painful or weak despite therapy.
A Defined Recovery Plan
After repair, a sling is typically used for about 2 to 4 weeks, followed by phased physical therapy.
What to Expect at Your Evaluation
Your first visit is focused on understanding the problem and outlining clear options.
When the pain started, whether there was an injury, night pain, and which motions are weak.
X-rays are usually obtained first. MRI is used when it will change treatment or when surgery is being planned.
Findings and options are explained in plain language, with time for your questions.
When to Have a Possible Rotator Cuff Tear Evaluated
- New weakness after a fall or lifting injury
- Night pain that keeps returning
- Difficulty raising the arm overhead
- Pain lasting more than a few weeks despite rest
- Weakness after a shoulder dislocation in an adult
From Conservative Care to Surgical Options
Treatment is matched to the tear and to how the shoulder functions. Each surgical option is discussed along with its expected recovery.
Nonoperative Treatment
- Physical therapy for rotator cuff and scapular strength
- Activity modification
- Injections when indicated
This page is educational and does not replace an individual evaluation. After rotator cuff repair, a sling is typically used for about 2 to 4 weeks; see the shoulder surgery recovery guide for the phases that follow.
Read More Before Your Visit
In-depth guides written to help you understand your diagnosis and recovery.
The sling phase, the stages of physical therapy, and milestones for driving, work, and sport.
Condition GuideRotator Cuff Tear TreatmentWhich tears typically respond to therapy and which may benefit from arthroscopic repair.
Symptom GuideShoulder Pain: Causes & TreatmentWhere your shoulder hurts and what it can point toward.
Frequently Asked Questions
A full-thickness tear does not heal back to the bone on its own, but pain and function often improve with physical therapy and activity modification. Partial-thickness tears are commonly treated with therapy first.
No. Many tears, especially degenerative tears, are treated with therapy first. Repair is considered for many acute injury tears and for tears that stay painful or weak despite nonoperative care.
A sling is typically used for about 2 to 4 weeks after repair, depending on the tear and the repair. Physical therapy then progresses in phases.
Night pain is common with rotator cuff problems, and lying on the affected side often makes it worse. It is one of the more common reasons patients seek an evaluation.
Usually not. X-rays are usually obtained first. MRI is used when it will change treatment or when surgery is being planned.
Call (484) 526-1735 during office hours or schedule online through St. Luke’s. Please ask about current appointment availability when you call.
Referral requirements vary by insurance plan. Many plans allow direct access to orthopedic specialists, while others require a referral from your primary care physician. Office staff can verify your plan’s requirements when you call to schedule.
Questions About a Possible Rotator Cuff Tear?
Visits are at 153 Brodhead Road, Rear Entrance, Bethlehem, PA 18017, for patients from Bethlehem, Allentown, and across the Lehigh Valley.
Schedule Online at St. Luke’sCall (484) 526-1735