Rotator Cuff Tear

What is a Rotator Cuff Tear?

A rotator cuff tear occurs when one or more of the four rotator cuff muscles or their tendons are partially or completely torn. It’s a leading cause of shoulder pain and weakness, especially in athletes and active adults who perform repetitive overhead movements.

Common Symptoms

• Pain with overhead or reaching activities

• Weakness lifting or rotating the arm

• Pain at night, especially lying on the shoulder

• Limited shoulder motion or loss of function

Physical Therapist Diagnosis

A PT will evaluate shoulder strength, range of motion, posture, and mechanics. Special tests such as the empty can, external rotation resistance, and drop arm test help identify tears. Palpation and functional movement screens provide additional insight.

Why it Happens

Rotator cuff tears may result from acute trauma (such as a fall or heavy lift) or from chronic overuse and tendon degeneration, especially in overhead athletes or aging adults.

Why it Doesn’t Always Heal on Its Own

Tendons have limited blood supply, making spontaneous healing difficult. Without rehab, weakness and compensation patterns persist, often worsening over time.

Ideal Physical Therapy Treatment

Rehab focuses on restoring motion, reducing pain, and strengthening the cuff and scapular stabilizers. Dry needling can help decrease muscular tension and improve activation.

Key strategies include:

• Manual therapy to improve shoulder and thoracic mobility

• Dry needling for shoulder and upper back muscle tightness

• Targeted strengthening of the rotator cuff and scapular muscles

• Neuromuscular retraining for overhead control

• Activity modification and gradual return to sport

Expected Outcomes

Partial tears often respond well to rehab, restoring strength and reducing pain. Full tears may require surgery, but therapy is critical both before and after surgery.