Rotator cuff tear

Conditions
Written by Chris Greenslade

A rotator cuff tear is a split or tear in one or more of the four tendons that help lift and turn the arm. Many tears develop slowly with age and some cause no symptoms at all. When they do cause pain or weakness, exercise-based rehabilitation is often the first step, and surgery is an option for some people.

Also known as torn rotator cuff, supraspinatus tear, cuff tear

How commonRotator cuff changes, including tears, become much more common with age. A large review found them in around 1 in 10 people aged 20 or under and in over 6 in 10 people aged 80 or over, often in people with no symptoms.1

Symptoms

  • Pain on the outside of the shoulder or upper arm
  • Weakness when lifting the arm or turning it outwards
  • Night pain, especially lying on the affected side
  • Difficulty with overhead tasks such as reaching a cupboard
  • Sudden weakness after a fall or heavy lift (traumatic tear)

Causes and risk factors

  • Age-related tendon changes, the most common cause
  • A fall onto an outstretched arm or a sudden heavy pull
  • Repeated overhead or heavy manual work

What the evidence says helps

  • A Cochrane review found that for mostly older adults with non-traumatic tears, surgery probably gives little or no extra improvement in pain at one year compared with exercise-based treatment.2
  • Another review found small advantages for repair over non-surgical care for pain and function up to two years, but these were below the level patients usually notice.3
  • Exercise and manual therapy are reasonable first-line options. One Cochrane review found exercise led to less pain improvement than surgical repair, but similar function.4
  • Most research involved older people whose tears came on without a major injury. The findings may not apply to tears caused by a fall or accident, which should be assessed promptly.2

Things you can try at home

  • Keep the shoulder moving within comfortable limits to avoid stiffness.
  • Work on strength in the shoulder and shoulder blade muscles with a graded programme.
  • Break heavy or overhead tasks into smaller chunks and keep loads close to your body.
  • Use a pillow to support the arm at night.

When to get urgent help

Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:

  • Sudden inability to lift the arm after a fall or injury: seek prompt assessment via your GP, NHS 111 or an urgent treatment centre.
  • A visible deformity, severe pain or being unable to move the arm after a fall or blow: go to A&E or an urgent treatment centre.
  • A hot, red, swollen shoulder with fever or feeling generally unwell: get same-day help from your GP or NHS 111, as this can signal a joint infection.
  • Shoulder pain that comes with chest pain, tightness, breathlessness, sweating or feeling sick: call 999, as this can be a heart problem.
  • New weakness, numbness or pins and needles spreading down the arm, or loss of feeling in the hand: see your GP urgently or call NHS 111.

How Apollo can help

We assess shoulder strength and movement, including objective strength testing where useful, and explain what your findings mean. Our team designs a progressive rehabilitation plan around your daily life and goals, with hands-on care where appropriate. If you are waiting for or recovering from surgery, we offer prehab and post-operative rehab, and we refer back to your GP or surgeon when further investigation is needed.

Osteopathy Clinical exercise Surgical rehab VALD movement testing
Chris GreensladePrincipal OsteopathRebecca BastenOsteopath
Book an appointmentCall 01603 736238

No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.

Related reading

Frequently asked questions

Can a rotator cuff tear heal without surgery?

A torn tendon may not knit back together fully, but many people's pain and function improve a great deal with exercise. Other muscles can learn to share the work. Research on non-traumatic tears in older adults shows similar results with or without surgery for most people.

When is surgery recommended for a rotator cuff tear?

Surgery may be considered after a significant injury, in younger active people, or when pain and weakness persist despite good rehabilitation. The decision is made with an orthopaedic surgeon, weighing your goals, the type of tear and the risks.

Will a scan show if I have a rotator cuff tear?

Ultrasound or MRI can show a tear. But tears are common in people with no pain, so a scan result needs to be matched with your symptoms and examination.

References

  1. Teunis T et al. (2014). A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. Journal of Shoulder and Elbow Surgery. View source
  2. Karjalainen T et al. (2019). Surgery for rotator cuff tears. Cochrane Database of Systematic Reviews. View source
  3. Brindisino F et al. (2021). Rotator cuff repair versus nonoperative treatment: a systematic review with meta-analysis. Journal of Shoulder and Elbow Surgery. View source
  4. Page M et al. (2016). Manual therapy and exercise for rotator cuff disease. Cochrane Database of Systematic Reviews. View source

This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.

Chris Greenslade
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