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Condition
Rotator cuff tear.
A rotator cuff tear is a partial or full-thickness tear of one of the four tendons stabilising the shoulder. Many partial tears respond well to progressive resistance rehabilitation without surgery; full-thickness tears in active patients often need a surgical opinion.
What it feels like
Signs and symptoms.
Pain on the outside of the shoulder, weakness lifting the arm, and difficulty reaching overhead or behind the back. Night pain — especially lying on the affected side — is a classic sign. Reaching for a seatbelt or lifting a kettle can reproduce it.
Who it affects
Overhead workers, athletes, and older adults.
Common in painters, mechanics, and swimmers, and in adults over 55 where tendon quality declines. A sudden tear can follow a fall on an outstretched hand; degenerative tears build up over months of overuse.
Diagnosis
Clinical exam first, imaging second.
A physiotherapist can identify most tears from a set of resisted-strength and impingement tests. Ultrasound or MRI confirms the size and location when surgical opinion is being considered.
Treatment
Rehab first for most partial tears.
Progressive resistance rehab targeting the rotator cuff, scapular stabilisers, and thoracic mobility resolves symptoms in most partial tears within 8–12 weeks. Full-thickness tears in patients under 60, or tears that fail rehab, warrant an orthopaedic opinion.
When to book
Don't tough it out.
Shoulder pain that lasts more than two weeks, wakes you at night, or limits work should be assessed. Untreated cuff injuries tend to progress, and delayed presentation limits treatment options.
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