Torn Rotator Cuff: Symptoms, Causes & PT Treatment
Updated July 20261 minute read
A torn rotator cuff is a tear in one of the tendons that lift and steady your arm. It can happen suddenly from an injury or gradually with age. Signs include shoulder pain, night pain, and weakness lifting the arm. Many tears — especially gradual, partial ones — are managed successfully with physical therapy and don't need surgery. Larger or sudden traumatic tears with major weakness should be evaluated promptly.
What is a rotator cuff tear?
A tear means one of the cuff tendons is partially or fully disrupted. Degenerative tears develop slowly with age (and are often present in pain-free shoulders), while traumatic tears follow a fall or forceful pull.
Symptoms
Common features are pain on the outer shoulder, night pain, and weakness — especially lifting the arm out to the side or overhead. A large sudden tear can cause marked weakness right away.
What causes it / risk factors
Age-related tendon changes, repetitive overhead work, smoking, and a single forceful injury all contribute. Tear size and your activity goals shape the treatment plan.
How it's diagnosed
A clinician uses strength and movement tests; ultrasound or MRI can confirm and size a tear when it would change management.
Physical therapy treatment
What a PT does. Your therapist restores motion, strengthens the surrounding muscles to compensate and offload the tendon, and improves shoulder-blade control. Exercises & progression (overview). Graded cuff and scapular strengthening and movement retraining. For many degenerative and partial tears, PT produces good outcomes comparable to surgery. Recovery timeline. Non-surgical programs often span 3 months or more; surgical recovery is longer and always includes PT.
Treatment options compared
PT is appropriate first-line for many tears. Surgery is considered for large traumatic tears, significant weakness, or when conservative care fails — and rehab is essential afterward.
Red flags
Seek prompt care for sudden major arm weakness after an injury, a deformed shoulder, a hot feverish joint, or arm pain with chest pressure (emergency).
Frequently asked questions
Sources (3)
- AAOS OrthoInfo: Rotator cuff tears. — AAOS OrthoInfo
- MedlinePlus: Rotator cuff problems. — NIH/MedlinePlus
- Kuhn JE, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study (MOON Shoulder Group). J Shoulder Elbow Surg. 2013. — PubMed
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.