Rotator Cuff Injuries

By Amelia Son, PTA, Site Coordinator


Rotator cuff injuries can occur in many shapes and sizes and can be a result of a single injury, or wear and tear over time. The rotator cuff consists of a group of muscles and tendons that help hold your upper arm bone, the humerus, into the shoulder socket. Those that perform repetitive overhead movements for work or sport are more likely to receive these injuries.

Rotator cuff anatomy and musculature.

Image of the Rotator Cuff Muscles.

Symptoms of a Rotator Cuff injury

Symptoms can be broad and sometimes pain can be minimally involved. The following are common symptoms of a rotator cuff injury:

  • A dull ache felt deep in the shoulder.
  • Increased pain when sleeping on the affected shoulder.
  • Weakness in the arm.
  • Cannot reach behind back or head.
  • A sharp, short-lived pain.

If the pain is sharp and short-lived, it is better to see a doctor quickly to evaluate if there is a tear.

Risk Factors for Rotator Cuff Injuries

There are a few risk factors that can increase our chances of receiving a rotator cuff injury.

  • Sports: Sports like tennis and baseball, with repetitive upper extremity use can cause injury.
  • Age: As you get older, your chance of injury increases due to degeneration and wear and tear on the tendon.
  • Hard Labor Jobs: Construction, painting, carpentry; again jobs that require heavy lifting and repetitive upper extremity use can increase risk of injuring your rotator cuff.

Diagnosis of Rotator Cuff Tears

Rotator cuff injuries are diagnosed by a doctor and can include but are not limited to the following:

  • Physical exam: The doctor will move your arm in all directions to determine lack of motion or pain in a position. The doctor will also test your strength to determine if there is any loss of strength.
  • X-rays: The doctor may order an X-ray to view the bones in your shoulder. While they cannot show a rotator cuff injury, it can possibly show issues with bones, such as spurs or arthritis, that can be the cause of pain
  • MRI: An MRI can show tissue quality and will show if there is a tear in any of tendons or muscles in the rotator cuff.

Treatment of Rotator Cuff Tears

Treatments for rotator cuff injuries can vary from surgery to conservative treatments, like physical therapy.  More often than not, an MD will suggest physical therapy to start before they decide on surgery. Physical therapy can provide you with range of motion and strengthening exercises to increase the muscles in the rotator cuff to allow for use of the arm and decrease weakness. If conservative treatment does not increase strength and decrease symptoms, surgery may be scheduled. The following surgeries are often performed for rotator cuff injuries:

  • Arthroscopic Tendon Repair: This is most often used to repair rotator cuff injuries. Small incisions are used to allow the surgeon to go in with a camera and repair the tendon and reattach it to the bone
  • Open Tendon Repair: This is used when it is better for the repair to have more space to work. The surgery is basically the same as the arthroscopic although it may be more uncomfortable during recovery since the incision is larger
  • Tendon Transfer: This is used when the tendon is too damaged to be reattached. The doctor may use another nearby tendon to replace the damaged one.
  • Shoulder Replacement: If the injury is extreme, the surgeon may opt to replace the shoulder joint instead of repairing the tendons.

After all of these surgeries, physical therapy will be ordered to regain range of motion and strength in the shoulder.

If you think you may have a rotator cuff injury, do not hesitate to call one of our MDs here at (904) JOI-2000 to get an appointment to be evaluated.


All JOI Physicians, Physical Therapists and Occupational Therapists now offer Telemedicine services for virtual visits from the convenience of your home.

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