Everything You Need to Know About a Rotator Cuff Tear

What is a Rotator Cuff Tear?

A rotator cuff tear is when one or more of the four small muscles and tendons that stabilise the shoulder joint become partially or completely torn. These muscles help lift and rotate the arm and keep the shoulder joint stable. A tear can happen suddenly due to injury or develop gradually over time due to wear and tear. It can cause pain, weakness, and reduced shoulder movement.

An analogy…

Think of the rotator cuff like the strings on a puppet, they keep everything aligned and moving smoothly. If one of those strings snaps or frays, the puppet (your arm) doesn’t move properly anymore, it might feel weak, painful, or unstable.

What are other names that a rotator cuff tear can be referred to?

Torn Rotator Cuff, Rotator Cuff Strain, Supraspinatus Tear, Supraspinatus Strain

What causes a rotator cuff tear?

The rotator cuff is made up of four muscles: supraspinatus, infraspinatus, subscapularis, and teres minor. These muscles form a cuff around the shoulder joint and are key in stabilising and controlling movement. A tear can occur from acute trauma like a fall or heavy lift, or through chronic overuse and degeneration, especially with repetitive overhead movements. Tears most commonly involve the supraspinatus tendon, which runs through a narrow space and is prone to compression and irritation.

What are the signs and symptoms of a rotator cuff tear?

Shoulder pain, especially when lifting the arm or sleeping on the injured side
Weakness in the shoulder, particularly during lifting or rotating movements
Limited range of motion
A feeling of catching or clicking in the joint
In severe tears, you might be unable to lift the arm above shoulder height
Pain may be sharp after an injury or dull and aching if it’s a degenerative tear

What tests are used to diagnose a rotator cuff tear?

Drop Arm Test: This test checks for a full-thickness rotator cuff tear, especially in the supraspinatus muscle. The patient lifts their arm out to the side (abduction) and slowly lowers it. If the arm drops suddenly or can’t be controlled, or if the movement causes pain or weakness, the test is considered positive.

Empty Can Test: This test targets the supraspinatus tendon. The patient holds their arm out in front at about a 45-degree angle (like pouring out a can), with the thumb pointing downward. The practitioner applies gentle downward pressure. If this causes pain or weakness, it may indicate supraspinatus strain or tear.

How long does a rotator cuff tear take to heal?

Recovery depends on whether the tear is partial or full, and whether it’s treated non-surgically or surgically. Partial tears often improve in 6 to 12 weeks with rehab. Full-thickness tears that require surgery may take 3 to 6 months or more to fully recover. Return to sport or heavy lifting can take up to 9 months, especially if surgery is involved.

How does a rotator cuff tear happen?

Repetitive overhead work or sport
Poor shoulder posture or biomechanics
Heavy lifting or sudden pulling movements
Trauma
Previous shoulder injuries or weakness in stabilising muscles

What treatment can help a rotator cuff tear?

Manual therapy to reduce muscle tension and improve joint alignment
Targeted rotator cuff and scapular strengthening exercises
Postural correction and ergonomic changes

What exercises or stretches can I do for a rotator cuff tear?

Isometric rotator cuff holds
Scapular stabilisation exercises
Resistance band external and internal rotations
Wall walks and pendulum exercises
Postural drills and core work

What products can help with a rotator cuff tear?

Pendular exercises

Lean onto a table with your good arm, letting your affected arm dangle forwards in front of you.
Using gentle movements of the body, let this arm swing backwards, forwards, side to side, and in circles.
The more you lean your body forwards, the more you will exercise the arm.

Resisted Shoulder abducted extension with external rotation in standing

Wrap one end of a long piece of a resistance band around each of your hands and thumbs.
Bend your elbows to 90 degrees with your palms facing down.
Start by rotating your palms up and spreading your thumbs and fingers wide.
Relax your shoulder blades gently back and down while turning your forearms outwards, keeping your elbows by your side.
Extend your wrists backward as you spread your fingers and thumbs even more.
Now start to extend your elbows, straightening your arms.

Shoulder flexion with stick in scaption (wide grip)

Hold a stick in both hands in front of you.
Lift your arms forwards and up, using the stick to help this movement.
Make sure you do not hunch your shoulders up.

Sleeper Stretch

Lie on your affected side, with the arm out in front and elbow bent to 90 degrees.
Place your other hand on the back of your wrist, and push down to rotate the forearm.
Make sure you do not hunch your shoulder up.
You will feel a stretch over the back and top of the shoulder.

Pectoral stretch into corner

Stand up straight facing into the corner of a room.
Bend both elbows and place your forearms on each wall, palms facing forwards.
Step forwards onto one leg and take your weight in the same direction, directly into the wall.
Make sure you shift your hips and body forwards.
You should feel a stretch across the front of your chest.
Hold this position.
The height you place your arms at will alter the area you feel the stretch.

Levator scapula stretch

Start in a seated position.
Place the hand of the side you want to stretch behind your back.
Take the opposite hand and pull your head forwards and to the opposite side at an angle, until you feel a stretch from the base of your skull down into your shoulder blade.
Hold this stretch.

Upper trapezius stretch

Start in a seated position.
Place the hand on the symptomatic side under your chair.
Take your other hand and place it on your head.
Tilt your ear directly down towards your shoulder and hold this position.
You should feel a stretch down the side of your neck.

Latissimus dorsi stretch wall

Stand sideways to a door frame and take one step away.
Hold the frame with your hand, keeping your elbow bent.
Move your outer arm over the top of your head in an arch.
Hold the frame further up, curving your body over.
You should feel a stretch up your outer side and in to your upper arm.
Hold this position.

Isometric shoulder flexion

Sit or stand up straight facing a wall.
Keep your affected arm by your side and bend your elbow to 90 degrees.
Place your fist against the wall.
Without moving your body, press your fist into the wall.
Hold this position and then relax.

Isometric shoulder external rotation

Sit or stand up straight next to a wall.
Keep your affected arm by your side and bend your elbow to 90 degrees.
Place the back of your wrist against the wall.
Without moving your body, press your wrist into the wall as if turning your forearm outwards.
Hold this position and then relax.

Chin tuck

Stand straight, looking ahead, and place two fingers on your chin.
Push your chin so that your head goes straight back, lengthening through the back of your neck, and keeping your eyes forwards.
Hold, and then relax.

Shoulder abduction

Stand tall with your arms at your sides.
Pull your shoulder blades back and down towards your buttocks and raise your arms to the side until directly overhead.
Lower to the starting position and continue the movement to complete the set.

Isometric shoulder extension

Sit or stand up straight with your back to a wall.
Keep your affected arm by your side and bend your elbow to 90 degrees.
Place the back of your elbow against the wall.
Without moving your body, press your elbow backwards into the wall.
Hold this position and then relax.

Isometric shoulder flexion