How Do I Know If I Tore My Rotator Cuff?
Manhattan Physical Therapy
Why Rotator Cuff Tears Are So Common
Rotator cuff tears affect millions of adults every year and are one of the most common causes of shoulder pain seen in orthopedic and physical therapy clinics. Some people injure their shoulder suddenly during a fall or heavy lift. Others develop pain slowly over months or years without a clear injury.
What makes rotator cuff tears tricky is that symptoms don’t always appear right away. Many people continue using their arm, assuming the pain will resolve on its own. Unfortunately, delaying care can allow a small tear to worsen and make recovery more difficult.
Understanding what the rotator cuff does—and how injuries develop—can help you recognize when shoulder pain is more than just a strain.
What Is the Rotator Cuff and What Does It Do?
Your shoulder is a ball-and-socket joint designed for movement, not stability. Unlike the hip, the socket is shallow, which allows you to lift, rotate, reach, and throw—but also makes the shoulder more vulnerable to injury.
The rotator cuff is a group of four muscles and their tendons that surround the top of your upper arm bone (humerus). Together, they:
Keep the arm bone centered in the shoulder socket
Control lifting and rotation of the arm
Stabilize the shoulder during everyday and athletic movements
When one or more of these tendons becomes damaged or torn, the shoulder loses strength and control, leading to pain, weakness, and limited motion.
How Does a Rotator Cuff Tear Happen?
Rotator cuff tears usually fall into two main categories: degenerative and acute.
Degenerative (Wear-and-Tear) Tears
These develop slowly over time and are more common as we age. Tendons naturally lose strength and elasticity, often without noticeable symptoms at first. Repetitive shoulder movements increase the risk, especially in people who:
Perform frequent overhead work
Play sports like tennis, baseball, or swimming
Lift weights regularly
Have jobs that require repeated shoulder motion
Small tendon damage can progress silently until pain or weakness becomes difficult to ignore.
Acute (Sudden) Tears
Acute tears occur during a specific event, such as:
Falling onto an outstretched arm
Lifting something heavy with a sudden jerking motion
Shoulder dislocation or trauma
These injuries often cause immediate pain and may occur alongside other injuries, such as fractures or sprains.
Common Signs You May Have Torn Your Rotator Cuff
Rotator cuff tears don’t feel the same for everyone, but certain symptoms appear consistently in patients.
Pain at Rest or at Night
Shoulder pain that worsens when resting or lying on the affected side is a classic sign. Many people notice sleep disruption because they can’t find a comfortable position.
Pain With Specific Movements
Pain may occur when:
Lifting or lowering your arm
Reaching overhead or behind your back
Putting on a shirt or washing your hair
If the same movements trigger pain repeatedly, the rotator cuff may be involved.
Weakness in the Arm
You may feel:
Difficulty raising your arm
Loss of strength when rotating the shoulder
Fear of dropping objects
Weakness often signals tendon involvement rather than a simple muscle strain.
Popping, Clicking, or Crackling Sensations
Some people experience grinding or crackling when moving the shoulder. This sensation—called crepitus—can occur when the shoulder mechanics are disrupted by a torn tendon.
Worsening Pain Over Time
Degenerative tears often start with mild discomfort. Without proper care, pain can intensify, become constant, and interfere with daily activities.
How Doctors Diagnose a Rotator Cuff Tear
Diagnosing a rotator cuff tear starts with a detailed conversation about your symptoms. Your provider will want to know when the pain began, what movements make it worse, and whether there was a specific injury.
A physical examination usually follows. During the exam, your shoulder strength, range of motion, and response to certain movements are tested. Weakness with lifting or rotating the arm often points toward rotator cuff involvement.
If a tear is suspected, imaging may be recommended:
X-rays help rule out fractures or bone spurs but do not show tendons
Ultrasound can detect tendon damage and assess movement in real time
MRI provides the most detailed view of tendon tears, muscle quality, and tear size
Not every patient needs advanced imaging right away. In many cases, symptoms and exam findings guide the initial treatment plan.
Can a Torn Rotator Cuff Heal Without Surgery?
Many rotator cuff tears—especially partial or degenerative tears—can improve without surgery. The goal of non-surgical care is to reduce pain, restore movement, and strengthen the surrounding muscles to support the shoulder. Common conservative treatments include:
Activity modification to avoid painful movements
Anti-inflammatory measures to reduce swelling
Targeted physical therapy to restore strength and control
Research and clinical experience consistently show that structured physical therapy helps most patients return to daily activities with less pain and better function. Even when surgery is eventually needed, pre-surgical rehabilitation often improves outcomes.
Surgery is typically considered when:
Pain persists despite consistent conservative care
A large or full-thickness tear limits arm function
The shoulder weakness interferes with work or daily life
Why Delaying Treatment Can Make the Injury Worse
Ignoring shoulder pain may seem harmless at first, but continued use of a torn tendon can lead to:
Enlargement of the tear
Progressive muscle weakness
Tendon retraction, making repair more difficult
Muscle atrophy that limits long-term recovery
Small tears are easier to manage than large ruptures. Early evaluation helps prevent minor damage from becoming a long-term shoulder problem.
When Should You Get Medical Care for Shoulder Pain?
You should seek professional evaluation if:
Shoulder pain lasts longer than a few weeks
Pain disrupts sleep or daily activities
You notice increasing weakness or limited movement
Symptoms follow a fall or sudden injury
Don’t let shoulder pain slow you down. Get a professional assessment and a clear plan for recovery at Manhattan Physical Therapy. Call (212)-213-3480 to book your appointment.
What Patients Often Ask About Rotator Cuff Tears
Can I still exercise with a torn rotator cuff?
Can I still exercise with a torn rotator cuff?
Certain movements may worsen the injury. Guided exercises are safer than continuing unsupervised workouts.
Will the tear heal on its own?
Some partial tears stabilize with proper care, but full-thickness tears do not reattach without intervention.
Is shoulder pain always a rotator cuff tear?
No. Bursitis, arthritis, and nerve issues can cause similar symptoms. Proper evaluation is essential.
Can a torn rotator cuff lead to arthritis or permanent shoulder damage?
Yes, an untreated rotator cuff tear can contribute to long-term shoulder problems. When the rotator cuff no longer stabilizes the joint properly, abnormal movement occurs between the bones. Over time, this can lead to cartilage wear, joint stiffness, muscle atrophy, and a condition known as rotator cuff arthropathy.
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Alexander Liu
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Manhattan Physical Therapy
✆ Phone (appointments):
(212) 213-3480
Address: 385 5th Ave, Suite 503, New York, NY 10016
