All You Need to Know About Rotator Cuffs: Tears, Injury Tests, Physical Therapy and Rotator Cuff Surgery

You have a nagging pain in your shoulder… Should you see a shoulder specialist? Or do you just tough it out?

If the pain is affecting your work, recreational activities or how you live your everyday life, it’s a good idea to see an orthopedic shoulder surgeon for a consultation.

No matter if your shoulder pain is generalized or acute, getting it checked out is the first step to feeling better. And while you may be suffering from one of many different shoulder injuries, one of the most common injuries orthopedic specialists see are rotator cuff tears.

What Is A Rotator Cuff?

The rotator cuff is a delicate system of muscles and tendons in the shoulder (the infraspinatus, subscapularis, supraspinatus and the teres minor). Vital to shoulder stabilization, the rotator cuff keeps the head of the humerus (upper arm) in the glenoid fossa (socket) of the scapula (shoulder blade). 

Anterior view. Click to view interactive modules on shoulder anatomy, injuries and surgical treatments.

In layman’s terms, the muscles and tendons of the rotator cuff keep your arm connected to your shoulder and keep everything stable as you rotate through the joint. 

Partial vs Full Rotator Cuff Tears

The severity of rotator cuff injuries can vary significantly, from basic inflammation to complete tears that require shoulder surgery. 

To determine the severity of a rotator cuff injury, your orthopedic shoulder specialist will perform a range of rotator cuff injury tests. His or her initial examination will include a physical exam, in which the surgeon will move your arm around, test the strength of your shoulder and apply pressure to different areas in and around your shoulder. 

Based on the results of this initial rotator cuff injury test, your shoulder specialist may order an X-ray, ultrasound or shoulder MRI to further determine the severity of your rotator cuff tear.

Partial Rotator Cuff Tears and Minor Injuries

Inflammation of the rotator cuff can be painful; however, it’s considered a minor injury that typically will resolve itself with rest. Likewise, tendinitis and bursitis in the rotator cuff can also be a source of chronic shoulder pain. 

Impingement syndrome – also known as swimmer’s shoulder – is a minor shoulder injury that can lead to a full or partial rotator cuff tear if left untreated.

Posterior view.

And, of course, partial tears of the rotator cuff, like the one below, can leave you weak, impaired and in pain. 

Anterior view. Click for a video explanation of partial rotator cuff tears.

Full Rotator Cuff Tears

Anterior view. Click for a video explanation of full rotator cuff tears.

A fully-torn rotator cuff can be persistently painful or can result in acute pain following a snapping sensation in the shoulder. The only way to know if there is a tear or hole through the rotator cuff (most commonly the supraspinatus) is through the imagery tests mentioned above. 

Rotator Cuff Treatments

Nonsurgical Treatments for Minor Rotator Cuff Injuries

When it comes to any orthopedic or rotator cuff injury, it’s best to try conservative treatment options before jumping straight to surgery. While nonsurgical treatments may take weeks or months to get you back to your baseline of health, it is often preferable to surgical options.

Nonsurgical treatments for minor rotator cuff injuries include rest, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin and naproxen, steroid injections and physical therapy.

Physical Therapy

If you have tendinitis, bursitis, impingement syndrome or a partial rotator cuff tear, your shoulder surgeon may recommend physical therapy in lieu of rotator cuff surgery. Your physical therapist will help you stretch and strengthen your shoulder and the surrounding muscular structure with specific rotator cuff exercises you can do both at therapy and at home. 

Treating rotator cuff injuries with physical therapy can help save you from surgery down the road. And if you do end up needing surgery, physical therapy will be an important part of your post-surgery recovery process. 

Rotator Cuff Surgery

Full rotator cuff tears and some partial tears do require shoulder surgery. While the conservative approach to orthopedic care is preferred, some rotator cuff injuries necessitate surgical solutions. 

Thankfully, there are a variety of surgical options for rotator cuff tears, including arthroscopic tendon repair, open tendon repair, tendon transfer and – in severe and rare cases – shoulder replacement. Your orthopedic shoulder surgeon will recommend the best surgical option to treat your rotator cuff tear.

If you have any questions about rotator cuff injuries, shoulder pain or any other orthopedic injury, please feel free to contact our orthopedic specialists.

1 Comment


I like how you mentioned that it might be wise to consult with an orthopedic surgeon if the pain you have affects work or other recreational activities. My wife and I are thinking of looking for a shoulder surgery specialist because our son hurt his throwing arm while pitching in a baseball game last week. I think it’s a good idea for us to consider all of our options when hiring a reputable professional to help us get our son back into good health so he can start playing baseball again.

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