Health Articles / SHOULDER

How to Treat When a Rotator Cuff Tears

The main causes of rotator cuff tears typically stem from age-related degeneration, continuous heavy use, or injuries from accidents and sports activities.
High-risk groups for rotator cuff tears include the elderly, badminton players, tennis players, football goalkeepers, or those who use their shoulders repetitively for extended periods.
Symptoms of rotator cuff tear patients may include pain at night at the rotator cuff area or arm, especially when sleeping on the affected side, frozen shoulder, muscle weakness, or shoulder stiffness. However, the level of pain doesn’t always reflect the severity of the tear.
Diagnostic approaches begin with taking a history of previous activities and duration of joint pain on the shoulder, followed by specialized physical examinations to check for bruising, resistance testing, and range of motion assessments.
If rotator cuff tears are left untreated, there’s a risk of shoulder imbalance, shoulder bone displacement, reduced functionality, and progression to shoulder osteoarthritis.

Rotator cuff tear is one of the most common problems found in the elderly and athletes, resulting in the inability to use the body at full capacity and creating moving difficulties in daily life. Therefore, if you experience shoulder abnormalities such as rotator cuff pain during sleep or continuous pain for several days, you should visit a doctor to diagnose the cause and receive timely treatment. This article will introduce you to torn rotator cuff conditions, explaining causes, symptoms, and torn rotator cuff treatment methods to help patients regain their physical health and return to normal life.

Table of Contents

What Causes Rotator Cuff Tear?

Rotator cuff tear is a condition that can arise from multiple causes, whether from rotator cuff tendon degeneration, accidents, or other factors. It results in shoulder pain or ache and the inability to fully use the arm or shoulder. To understand this condition, it’s important to first learn about the causes of rotator cuff tear, which include:

Rotator cuff tendon degeneration

Patients, especially the elderly, often have increased risk for various illnesses, including rotator cuff tears. This is due to age-related tendon degeneration in the shoulder joint, combined with other contributing factors such as calcium deposits that accumulate in the shoulder joints. This condition can eventually cause friction between the shoulder bones and their tendons, leading to rotator cuff rupture.

Additionally, certain behaviors that weaken body tissues like smoking are also factors that can accelerate shoulder tendon degeneration, which can also result in torn rotator cuff conditions.

Heavy and prolonged use of shoulder tendons

Besides the elderly, athletes or those who use their bodies intensively also have high risk for rotator cuff tears, such as tennis or badminton players. They must use their shoulder area as a pivot point to generate force for hitting balls, causing shoulder tendons to deteriorate much faster. This eventually leads to rotator cuff tears.

Severe injury

Accidents in daily life or sports activities are factors that can cause shoulder tendon inflammation. Examples include falls particularly when the arm is extended to brace against the ground, falls where the shoulder strikes hard objects violently (like what can happen to football goalkeepers), or falls that hit the ground. If these injuries are left untreated for a long time without proper care, they may subsequently lead to rotator cuff tears. Additionally, in cases of young children whose body organs haven’t fully developed, experiencing accidents can also be a factor in developing this condition.

What Are the Symptoms of Rotator Cuff Tear?

Now that we know what causes rotator cuff tears, let’s look at what symptoms a torn rotator cuff presents so that everyone can observe themselves and receive timely treatment. Initially, patients will experience the following symptoms:

Pain in the arm area, especially the shoulder region, such as feeling pain at night when sleeping on the side with symptoms and pain in nearby areas such as the neck, shoulder blade, or pain radiating down the arm.
Frozen shoulder, unable to fully move the shoulder.
Pain when lifting or extending the arm, with constant joint stiffness.
Muscle weakness, unable to lift or hold objects.
Shoulder stiffness, unable to move the shoulder as desired.

Rotator cuff pain from torn rotator cuff varies among individuals, and the level of pain experienced cannot indicate the severity of the tear. This means some patients may experience severe pain while having a minor rotator cuff tear. On the other hand, some may feel only slight pain but they have severe tendon damage.

What Are the Differences Between Pain From Rotator Cuff Tear VS Pain From Exercise?

After exercising or moving the body more than usual, many people may experience muscle soreness or fatigue. This type of pain is called DOMS (Delayed Onset Muscle Soreness), caused by inflammation due to muscle cell tissue breakdown during exercise. Normally, these symptoms will subside within approximately 3-4 days.

However, if symptoms don’t improve after the abovementioned period, it may signal that something abnormal is happening in the body. If the symptoms involve pain at night when sleeping on the affected rotator cuff, and pain in the neck, shoulder blade area, and radiating to the upper arm, it’s necessary to see a doctor to diagnose whether it is a rotator cuff tear.

How to Diagnose Rotator Cuff Tear Symptoms?

When patients experience severe pain or ache from rotator cuff tears, it’s recommended to see a doctor as quickly as possible for timely diagnosis. The doctor will identify the cause of these symptoms and design an appropriate treatment program with the patient through the following steps:

Medical history taking

The doctor will inquire about initial patient information, such as previous activities, pain duration, or areas of pain.

Physical examination

This usually includes basic examinations such as weight, height, body temperature, and blood pressure, along with other tests to assess shoulder joint pathology and other potentially related organs. For example, patients will undergo checking for bruising, resistance testing by having patients resist the doctor’s force, range of motion assessments by observing shoulder joint movement, checking whether shoulder blade muscles are inflamed or tight, etc.

X-ray

It is an additional assessment to visualize shoulder joint balance, identify whether patients have accompanying bone fractures, and check for calcium deposit problems in the shoulder joint. However, X-rays cannot visualize tendons.

MRI (Magnetic resonance imaging)

This diagnostic technology uses electromagnetic waves to examine muscles, tendons, bones, and shoulder joints to obtain more detailed information for assessing injuries and planning appropriate treatment.

How to Treat Rotator Cuff Tear?

There are many ways to treat torn rotator cuff, from avoiding risky behaviors to treatment with medications and other approaches. Doctors will design treatment programs with patients and select appropriate treatment methods for each patient to help eliminate these injuries or pain. Rotator cuff tear treatment approaches are as follows:

Behavioral modification

For patients with non-severe rotator cuff tears, doctors will initially have patients avoid various risky behaviors. By reducing activities that require shoulder use, such as reaching overhead or lifting heavy objects, patients can prevent increased tearing and risk of spreading infection.

Medication use

If patients continue to experience joint pain or ache on shoulder or arm areas and cannot fully use these parts, doctors will prescribe pain relievers such as anti-inflammatory drugs or muscle relaxants, including steroid medications, to reduce severity levels of the injury and effectively treat rotator cuff tear symptoms.

Additionally, if patients take medications and modify behaviors but still experience pain, doctors may consider injections with steroidal or non-steroidal anti-inflammatory drugs to relieve pain and inflammation instead.

Physical therapy

For patients with non-severe torn rotator cuff cases, possible treatment may be medication combined with physical therapy as it helps reduce pain, repair the body, and recover from injuries more effectively. Doctors may consider using laser ultrasound or shockwave therapy for treatment.

Surgery

Torn rotator cuff treatment through surgery is commonly used when doctors diagnose the cause and find severe tendon tears or patients still experience severe shoulder pain after receiving other treatments. For example, those who use their shoulders heavily, those who experience serious accidents, or those with calcium deposits in shoulder joints will undergo rotator cuff tear surgery.

Treatment involves repairing torn rotator cuff tendons or reattaching them to the bones through arthroscopic rotator cuff repair, which is a surgical method inserting small cameras into the body to record internal images before performing surgery. One of the advantages of this surgery is to have small wounds, allowing for faster body recovery and helping reduce risks of subsequent complications. However, patients need approximately 4 weeks or 1 month to recover after surgery, followed by physical therapy for approximately 3-4 months depending on the patient’s recovery efficiency to ensure complete injury healing.

What Happens If Rotator Cuff Tear Symptoms Are Left Untreated?

Leaving any injuries untreated certainly won’t benefit patients. Besides severe pain or increased rotator cuff tendon damage, the risks of not promptly treating torn rotator cuff are such as:

Shoulder Imbalance: If left untreated for long periods, shoulder joints may become imbalanced, such as shoulder bones shifting upward. This hinders the patient in fully using the shoulder joints and potentially leads to shoulder osteoarthritis.
Shoulder osteoarthritis: Patients will experience pain and inability to move or use shoulder joints normally.

Rotator cuff tear is a problem that can affect anyone, especially the elderly, resulting in severe pain along with risks of developing various diseases and complications. Additionally, it can also affect athlete groups such as badminton players or football goalkeepers because they heavily use their shoulders in repetitive motions and are at risk of falling with shoulder impact. Therefore, when shoulder abnormalities occur, immediately see a medical specialist who will diagnose and provide appropriate treatment guidelines personalized for each patient. Whether through medication, physical therapy, or surgery, rotator cuff tear treatment helps patients return to normal, happy lives.

An article by Navaphan Vawklang, M.D., Experienced Sports Medicine and Shoulder Surgeon

Consult symptoms before scheduling an appointment.

Fri, 19 Sep 2025