Rotator Cuff Tear

The rotator cuff is a group of muscles and tendons in each shoulder. 

What is it?

 The rotator cuff is comprised of four tendons that attach muscles from the shoulder blade to the humerus (upper arm bone). The subscapularis tendon runs across the front of the shoulder, the supraspinatus tendon runs over the top of the shoulder, and the infraspinatus and teres minor tendons run behind the shoulder. Collectively, these tendons create a sleeve over the shoulder that help lift and rotate the arm in the glenohumeral joint (shoulder socket). The rotator holds your upper arm bone in your shoulder socket. It keeps your arm stable while allowing it to lift and rotate. Too much stress on the rotator cuff can cause a tear.

What causes it?

A rotator cuff tear can happen because of a fall with an outstretched arm. It can happen if you try to lift something heavy with a jerking motion. It can also happen over time as part of normal wear and tear of aging, especially if you have done a lot of repetitive shoulder motions. This can be a painful injury.

A rotator cuff tear is caused by a partial or full tear of any of these four tendons and the most commonly affected tendon is the supraspinatus. Rotator cuff tears result acutely from direct or indirect trauma, abrupt overhead arm movements, or repetitive reaching motions. For example, direct hits to the shoulder in football, abrupt movements like cranking a lawn mower, and repeated movements like pitching a baseball. Tears can also occur chronically from long term tendinopathy (inflammation of the tendon) that leads to a tear. 

signs and symptoms

Rotator cuff tears cause anterolateral pain (on the front and to the side) of the shoulder and upper arm and it is intensified while reaching up, out or behind. Pain at night while sleeping is also common. Tears resulting from acute trauma require surgical repair. It may hurt even when you are resting. It may hurt more when you lift or lower your arm. Your arm may feel weak when you try to move it. You may feel a crackling sensation when you move your shoulder certain ways.

non-surgical treatment

Non-surgical treatment options include physical therapy, activity modification, oral anti-inflammatory medications (NSAIDs), ice and occasionally steroid injections. 

surgical treatment

If pain continues despite these non-surgical attempts or the tear is a complete tear, surgical repair is frequently recommended to alleviate pain and restore function. Our surgeons can create a plan that is right for you. For more information, contact Andrews Sports Medicine & Orthopaedic Center at (205) 939.3699 and ask to speak with one of our surgeon's appointment schedulers.


At The Shoulder Center at Andrews Sports Medicine, our fellowship-trained non-surgical physicians and orthopaedic surgeons provide the most-advanced, comprehensive treatment solutions for injuries and disorders of the shoulder. To schedule an appointment, call (205) 939-3699.

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