Common causes and risk factors

• Age-related tendon wear

• A fall, dislocation or sudden pulling injury

• Repetitive overhead work or sport

• Smoking, diabetes and other factors that affect tendon health

Symptoms and signs

• Pain over the side of the shoulder

• Night pain

• Weakness lifting or rotating the arm

• Difficulty with dressing, reaching or work

• Sudden loss of function after trauma

How is it diagnosed?

Examination assesses strength and movement. X-rays show the bones and arthritis; ultrasound or MRI can show the tendons. The scan result is considered alongside symptoms because rotator cuff tears become increasingly common with age and may be painless.

Treatment options

Many degenerative tears improve with physiotherapy, activity modification and pain management. Surgery may be discussed for an acute traumatic tear, substantial weakness, a large or progressing tear, or continuing symptoms despite rehabilitation. Repair is usually performed using keyhole surgery, followed by a sling and several months of rehabilitation.

When should I see a specialist?

Arrange an assessment if you have:

• Sudden weakness after a fall or injury

• Inability to raise the arm

• Persistent pain and weakness despite physiotherapy

• A known tear with worsening function