What is a Rotator Cuff Injury/Tear?

What is a Rotator Cuff Injury/Tear?

The rotator cuff is a group of muscles and tendons surrounding the shoulder joint that provide strength for shoulder motion. A rotator cuff tear occurs when one of these tendons detaches from the bone, usually from overuse or traumatic injury. Rotator cuff injuries are common among older adults, and this type of injury increases with age.

A torn rotator cuff injury weakens the shoulder and often causes discomfort with use and while sleeping at night. This injury can cause pain ranging from a dull ache to sharp pain that worsens with activities requiring the arm to move away from the body. This pain can make daily activities, such as getting dressed, lifting, reaching, and pulling more difficult.

Rotator cuff tears vs. sprains

Rotator cuff conditions fall into two main categories: inflammation and tears. Most rotator cuff injuries are wear-and-tear overuse conditions, caused by repeated arm movements over time. The tissues in the rotator cuff can break down, leading to conditions such as tendinitis and bursitis. Rotator cuff tears can occur gradually from repetitive motion or suddenly from overloading, such as from a bike fall or crash. Tears to the rotator cuff tendon can either be partial or full.

Types of Rotator Cuff Tears


 There are four main types of rotator cuff tears:

  • Partial tears: Also called incomplete tears; the tendon is damaged but is still somewhat connected to the bone and is still "water tight"
  • Complete tears: Also called full-thickness tears; the tendon completely separates from the bone, resulting in a rip or hole
  • Acute tears: These tears occur suddenly, often the result of falling or incorrectly lifting something too heavy. They may also occur at the same time as other shoulder injuries (such as a dislocated shoulder or broken collarbone).
  • Degenerative tears: These tears happen slowly over time and are often the result of repeated shoulder motions that stress the rotator cuff muscles and tendons; they are more commonly found in the dominant arm. Factors contributing to degenerative rotator cuff tears include repetitive stress, aging, and bone spurs that develop and weaken the tendon over time.

Signs & Symptoms of a Sprained Ankle


Signs and symptoms of rotator cuff tears differ depending on the type of tear. Sudden tears are more likely to cause intense pain, while those that develop over time will likely cause mild to no discomfort. Most rotator tears, however, will cause some shoulder weakness. 
Signs of a rotator cuff tear may include:

  • Pain and/or difficulty raising or lowering the arm
  • Dull ache at the top part of the arm or shoulder, which may be become intense when lying down
  • Difficulty and/or increased pain when reaching behind the back
  • Weakness in the shoulder when trying to lift items
  • Popping/clicking sounds when moving the arm

What Causes a Rotator Cuff Injury/Tear?


Rotator cuff injuries may be the result of a substantial injury to the shoulder. For example, a fall or other accident that leads to a broken collarbone or dislocated shoulder can also cause a sudden tear in the rotator cuff.

It is more common, however, for rotator cuff tears to be the result of the tendon wearing down over a prolonged period with repeated use. Repetitive shoulder movements cause the tendon to become irritated and damaged. These degenerative tears are most common among adults who consistently repeat the same shoulder movements, such as carpenters, painters, and mechanics. Professional and/or recreational athletes are also at risk for degenerative rotator cuff tears.

Risk Factors

Risk Factors

Although anyone can experience a rotator cuff injury, the following factors can increase the risk of developing a rotator cuff tear:

  • Being over age 50
  • Having a family history of shoulder issues or rotator cuff injuries
  • Smoking
  • Working a job that requires a lot of reaching overhead or heavy lifting
  • Playing sports with repeated shoulder movements

Full-thickness rotator cuff tears do not heal on their own, and the pain and weakness will often increase over time if the tear progresses in size or severity. If left untreated, rotator cuff tears may become worse. This can lead to ongoing shoulder pain and difficulty using the injured arm. A large or massive complete rotator cuff tear can make it nearly impossible to move the affected arm. This loss of motion and increased weakness may become permanent without treatment.



Keeping muscles and tendons conditioned is important in the prevention of rotator cuff injuries and tears. The following activities can help you avoid injury:

  • Regular exercise that includes warming up
  • Stretching
  • Light strengthening activities
  • Keeping proper posture
  • Seeing a doctor if recurrent shoulder pain develops
Get Care

Trust NewYork-Presbyterian for Rotator Cuff Injury Care

If you are experiencing symptoms of a rotator cuff injury, including shoulder pain that worsens at night or interferes with sleep, chronic pain in the shoulder or arm, or weakness in the shoulder or arm, make an appointment with a doctor today. NewYork-Presbyterian is available to help with everything from traumatic sports injuries to chronic pain from overuse of arms, legs, or joints. Our providers are ready with the latest advances in both nonoperative and surgical care, all geared toward getting you back to the activities you love.