Rotator Cuff Tear — What You Need to Know

What Is the Rotator Cuff?

A group of 4 muscles whose tendons form a "cuff" around the humeral head. It stabilizes the joint and controls rotation and lifting movements. The most commonly affected tendon is the supraspinatus.

Degenerative vs. Traumatic

Degenerative — progressive wear and tear, common after age 50. It develops gradually.

Traumatic — from a fall on the arm or a sudden pull. Causes acute pain and immediate weakness. The distinction is important: traumatic tears in young patients have a clearer indication for surgical repair.

Symptoms

• Pain on the outer side of the shoulder
• Pain when lifting the arm
• Night pain
• Weakness
• Crepitus / crackling sounds with movement

Diagnosis

Clinical examination — specific tests (Jobe, drop-arm, lift-off).

Shoulder ultrasound — quick and accessible.

MRI — the gold standard investigation.

Treatment

Conservative — effective for many partial and degenerative tears: physical therapy, cortisone injections, PRP, activity modification.

Surgical — for complete tears in young patients, acute traumatic tears, and failure of conservative treatment. Massive tears may require a reverse shoulder replacement.

The Key Message

Not every tear requires surgery — but every tear requires an evaluation.

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