Rotator cuff tears

How do you tear your rotator cuff?

Rotator cuff tears are common. They tend to occur more often amongst people over the age of 50 than younger people in their 30s and 40s. Older people tend to get tears due to age-related changes. In fact, it’s so common almost 50% of people over 60 get them. One study showed that asymptomatic tears were twice as common as symptomatic ones! Younger and middle-aged people tend to get them due to trauma, trying to lift a very heavy object or catch something heavy. Tears can also happen from a fall onto the shoulder or arm. It can also occur from a boom-bust cycle too much too soon type of exercise such as trying a new sport and overtraining without sufficient strength and conditioning to support the shoulder. In older people, it tends to happen because of age-related changes from decreased blood supply to the tendons connecting muscles to bones.

Do I have a rotator cuff tear or a sore shoulder?

There are many conditions that can give you pain in the shoulder. Pain can be referred from the neck as well as other organs like the gall bladder, lungs, and even your heart. It’s important to know that your shoulder pain is not a symptom of any other condition. A good Physio (like all of us at Vitality Physio) will ask all the relevant questions to keep you safe.

Some of the most noteworthy features of rotator cuff tears are:

  • The affected shoulder hurts when lying on it while resting.
  • Pain when lifting or lowering the arm during simple activities such as reaching for a shelf.
  • A feeling that the shoulder is weak. It’s particularly noticeable when lifting your arm to shoulder level or when rotating your shoulder.

Does the rotator cuff always need surgery if it is torn?

Let’s take a closer look at the anatomy:

The rotator cuff tendons are special. They are all connected via the rotator cable. Therefore, they all work together to make the rotator cuff a continuous structure, working harmoniously together. The cable functions as a stress shield. It acts in the same way that a suspension bridge transmits loads across to its supporting towers.


Here’s the good news- this means that even when you have a large tear of a  rotator cuff tendon, you can sometimes neither have pain nor a loss of function!

However, tears that affect the function of the rotator cable are likely to need surgery. Therefore, the location, more than the size of the tear is more relevant in deciding whether surgery is needed.

How can Physiotherapy help?

It is important to address all factors that may have contributed to tendon injury or tear when treating rotator cuff injuries when surgery is not needed.

With physiotherapy, you will improve neck, scapular, and thoracic spine function. All of the body parts are integral to good shoulder function. If your neck is stiff or weak, your shoulder joint can often have to work harder. By targeting these supporting areas, you will improve the way your body is set up before you move your shoulder. This means that you give your shoulder the best chance to move both easily and powerfully.

As movement experts, Physios are great at distinguishing whether your joints have the stability to move efficiently too. So, we can help you get your shoulder working to its best potential.

We can help you find interim solutions to find more comfortable positions to sleep, and ways to modify your technique for activities, while you are recovering or getting stronger.

Now, generic exercises – off the internet will help to a certain extent; however, they cannot be replaced by robust, goal-orientated, and bespoke training plans. They are often not targetted to your individual needs, and it’s difficult to guess without an expert to guide you how often, how many repetitions, and how heavy to load your muscles.

To make improvements rehab should always be:

  1. Specific- meaning is it for endurance, strength, balance, flexibility, or a combination of these?
  2. Measurable- it needs to be scored.
  3. Prescribed- so that you know the:
  • Intensity: How many repetitions?
  • Sets: How many times should you repeat a particular number of repetitions of a given exercise?
  • Dose: How many sessions per week?

By working with a well-planned specific rehab program- you’ll make the best gains and use your time efficiently too!