A rotator cuff tear is an injury to one or more of the tendons or muscles that help hold your shoulder in place and move your arm. Your rotator cuff helps you lift your arm, reach overhead, rotate your shoulder, throw, serve, swing, and reach behind your back.
A tear can be partial, meaning the tendon is damaged but not fully torn, or full-thickness, meaning the tendon has torn more completely.
Rotator cuff tears are common in active adults because the shoulder does a lot of repetitive work, especially during sports, exercise, lifting, yard work, and summer activities.
What Causes Rotator Cuff Tears?
Rotator cuff tears usually happen in one of two ways: gradual wear and tear, or sudden injury.
Gradual Wear and Tear
This is very common. Over time, the tendons can become irritated, weakened, or worn down from repeated use. This can happen with age, repetitive motion, poor shoulder mechanics, or years of overhead activity.
Common examples include:
- Pickleball or tennis serves
- Volleyball hitting, serving, and blocking
- Swimming
- Weightlifting
- Repeated lifting or carrying
- Yard work
- Painting, cleaning, or overhead home projects
- Jobs that require reaching or lifting
Sudden Injury
A rotator cuff tear can also happen suddenly from a specific event, such as:
- Falling on your arm or shoulder
- Lifting something too heavy
- Jerking your arm suddenly
- Diving for a ball
- Swinging hard and feeling sharp pain
- Pulling something awkwardly
- A shoulder dislocation
A sudden tear is more concerning when it causes immediate pain, weakness, or trouble lifting the arm.
How Do You Know If You Have a Rotator Cuff Tear?
You usually can’t know for sure without an exam, but certain symptoms can point to a rotator cuff problem.
Common signs of a rotator cuff tear include:
- Pain on the front or outside of the shoulder
- Pain when lifting your arm
- Pain when reaching overhead
- Pain when reaching behind your back
- Weakness in the shoulder or arm
- Pain at night, especially when lying on that shoulder
- Trouble putting on a jacket, reaching into the back seat, or putting dishes away
- Clicking, popping, catching, or grinding
- Pain that worsens with activity
- A sudden sharp pain after a fall, lift, serve, swing, or pull
One major clue is weakness. General soreness may hurt, but you can usually still use the arm. With a rotator cuff tear, you may feel like the shoulder simply will not do what you are asking it to do.
What Does Rotator Cuff Pain Feel Like?
Rotator cuff pain often feels like a deep ache in the shoulder. It may be worse when you lift your arm away from your body or reach overhead.
You may notice pain when you:
- Put on a shirt
- Brush or wash your hair
- Reach for something on a high shelf
- Fasten a bra
- Tuck in your shirt
- Lift a bag of groceries
- Serve a pickleball or volleyball
- Sleep on the injured side
Pain that keeps waking you up at night is a common reason people finally get the shoulder checked.
Non-Surgical Treatment Options for Rotator Cuff
Many rotator cuff injuries can improve without surgery, especially if the tear is small, partial, or more related to irritation and inflammation.
Non-surgical treatment may include:
- Rest from painful activities
- Ice for soreness and swelling
- Anti-inflammatory medicine, if safe for you
- Physical therapy
- Shoulder and upper back strengthening
- Gentle range-of-motion exercises
- Activity changes
- Improving posture and shoulder mechanics
- Injections in some cases
Physical therapy is often a big part of recovery. It can help strengthen the muscles around the shoulder, improve how the shoulder blade moves, reduce strain on the tendon, and help you return to activity more safely.
Non-surgical treatment does not always “close” the tear, but it can reduce pain and improve function enough that many people do not need surgery.
Surgical Treatment Options for Rotator Cuff
Shoulder surgery may be considered if the tear is larger, symptoms are severe, or non-surgical care does not help enough.
Surgery may be more likely if:
- The tear happened suddenly
- You have major weakness
- You cannot lift your arm normally
- The tear is full-thickness
- Pain continues after therapy
- You need strong shoulder function for work or sports
- The injury is affecting daily life
Rotator cuff surgery usually involves repairing the torn tendon back to the bone. Recovery can take months and usually includes a sling, protected movement, physical therapy, and gradual strengthening.
Can You Prevent Rotator Cuff Tears?
Not every tear can be prevented, especially if it’s related to aging or a sudden fall. But you can reduce your risk.
Helpful prevention habits include:
- Warm up before sports
- Strengthen your shoulders, upper back, and shoulder blades
- Avoid doing too much too soon
- Use good form with lifting and sports
- Take breaks from repeated overhead activity
- Avoid lifting heavy items far from your body
- Balance pushing exercises with pulling exercises
- Don’t ignore shoulder pain that keeps returning
- Build activity gradually after time off
This matters a lot in summer, when people often jump back into pickleball, volleyball, swimming, biking, yard work, travel, and weekend activities all at once.
What Should You Do If You Think You Injured Your Rotator Cuff?
First, stop doing the activity that caused sharp pain. Do not keep testing it over and over to see if it still hurts.
A good first step is to:
- Rest from painful movements
- Ice the shoulder
- Avoid overhead lifting
- Avoid serving, throwing, swinging, or heavy carrying
- Keep gentle motion if it does not hurt
- Pay attention to weakness, night pain, and range of motion
You should get checked if the pain lasts, keeps coming back, wakes you up at night, causes weakness, or makes it hard to use your arm.
Get care sooner if you felt a pop, had a fall, cannot lift your arm, or suddenly lost strength.
Take Shoulder Pain Seriously, Early
A rotator cuff tear can cause shoulder pain, weakness, night pain, trouble reaching, and difficulty lifting your arm. Some injuries get better with rest, activity changes, and physical therapy. Others, especially larger or sudden tears, may need surgery.
The safest move is to take shoulder pain seriously, early. If you stop pushing through it and get the right help, you have a much better chance of getting back to pickleball, volleyball, swimming, workouts, yard work, and normal daily life without making the injury worse.
If you’re experiencing pain in your shoulder or worried about a rotator cuff tear, call (813) 253-2406 or fill out our online form to schedule a consultation with one of our orthopedic specialists. Tampa Orthopaedic & Sports Medicine is located in Tampa, FL, and proudly serves patients from the surrounding communities.
