Torn Rotator Cuff

By Alex Bigale, PTA

Torn Rotator Cuff

The shoulder is a ball (humeral head) and socket (glenoid/labrum) joint that allows a person to have a multidirectional arm movement.  This joint is held into place by a group of 4 muscles and tendons called the rotator cuff: Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis. These muscles provide support for the shoulder and assist with abduction, external rotation, and internal rotation.  The most frequently torn rotator cuff muscle is the supraspinatus due to its position. This muscle crosses a site under the acromial-clavicular joint when bone spurs typically occur. Dr. Kamal Bahsali explains rotator cuff injures in this VIDEO.

illustration of anatomy of Rotator Cuff muscles

Anatomy image of Rotator Cuff muscles.

Symptoms of a Torn Rotator Cuff

  • Pain on the outer portion of the shoulder.
  • Difficulty/pain when trying to sleep on that shoulder.
  • Pain with overhead movements.
  • Cracking/popping sensation with arm movements.
  • Weakness or inability to lift or rotate the arm.

Types of Torn Rotator Cuff

Full-thickness- This occurs when there is a complete tear of the muscle, separating the tendon from the bone.

Partial-thickness– The tendon has damage or wear and tear; however, it still connects to both the muscle and the bone.

Acute Tear– Usually caused by trauma such as a fall, a quick movement, or heavy lifting can also be caused.

Chronic Tear– AKA degenerative tear occurs over time as the tendon wears down.  Degeneration occurs as we age, but other factors can speed up the degeneration and make some people more susceptible to this type of tear than others.

Repetitive stress– Occurs with chronic overhead motions from baseball/softball, tennis, rowing, and weight lifting.

Bone spurs– These bone overgrowths typically occur on the underside of the acromion. They rub on the tendons of the RTC as we move our shoulders.  Over time this will wear down the tendon and make it more likely to tear.

Reduced Blood Supply:   If the tendons of the RTC do not receive adequate blood supply for prolonged periods of time, they are not getting the healing factors to help repair small tears that occur.

How to Diagnose a Torn Rotator Cuff

Diagnosis of a torn rotator cuff can be performed through a physical exam and imaging.  Specific tests, which will measure your strength and range of motion, will be performed by your physician to help rule out any other possibilities.  Most physicians will want to perform an MRI to confirm the tear. Also, calculate the size and significance of the possible tear to determine the treatment options.

Treatment Options for Rotator Cuff Injuries


Most physicians will attempt to prescribe non-surgical treatment options as an initial approach to allow the body to heal itself.  This is especially true if the patient only suffers a partial tear or is not a good candidate for surgery.  If a full-thickness tear is present, the body can be trained to have the arm’s functional use. This is true if the pain and inflammation are managed.

Non-surgical options include:

  • Rest.
  • Ice.
  • Anti-inflammatory medications.
  • Steroid injections.
  • Physical Therapy.

Surgical/Operative Management

With surgical advancements, recovery time and the ability to regain function have greatly improved over the years.  The surgeons at Jacksonville Orthopedic Institute are using the latest technology and up-to-date research, which allows them to perform RTC repairs where the tendon’s attachment to the bone is stronger and gives a patient a better chance of regaining full function and reducing risks of re-injury.

If you would like to learn more about a Rotator Cuff Infraspinatus Tear, please go to this article:

Physical Therapy for Rotator Cuff Tears

Following a rotator cuff repair surgery, a patient can expect to begin physical therapy (PT).  The initial phase of PT should consist of a passive range of motion performed by the therapist to minimize joint stiffening, causing problems down the road.  Once the surgeon determines that the healing process is far enough along, the patient will begin working on an active range of motion, followed by strengthening exercises.  JOI’s goal is to help improve athletes’ performance to reduce the risk of injury or re-injury.

If you have a rotator cuff tear’s condition or symptoms and would like to make an appointment with an Orthopedic Shoulder Specialist, please call JOI-2000.

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Alex Bigale, PTA

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