Rotator cuff tear pain is typically felt as a dull ache deep in the shoulder, often on the outer side, that can radiate down the upper arm towards the elbow (but usually stops there), especially with overhead arm movements, lifting, or when lying on the affected side at night, causing weakness and limited motion.
Two primary warning signs of a rotator cuff tear are persistent shoulder pain, especially at night or with overhead movement, and weakness or difficulty lifting and rotating your arm, often accompanied by a clicking or crackling sensation, making routine activities like combing hair or reaching behind your back challenging.
Symptoms of rotator cuff tendinopathy typically develop gradually and can be chronic, lasting for months. These symptoms may include: pain around the shoulder – most commonly at the lateral (outside) shoulder and/or upper arm, but pain can also be in the front or back of the shoulder.
Shoulder impingement syndrome
This results in pain and decreased motion. These symptoms can be mistaken for a rotator cuff tear, but the pain caused by shoulder impingement is diffuse and not sharp, like the pain caused by a rotator cuff tear.
Typically, you will feel pain in the front or side of your shoulder that radiates (travels) down the side of your arm. It may be present with overhead activities such as lifting or reaching (e.g., serving in tennis, throwing a ball, grabbing an item out of a high cabinet).
Pain is more likely in the front of the shoulder and may travel to the side of the arm. The pain always stops before the elbow. If the pain goes down the arm to the elbow and hand, this may indicate a pinched nerve in the neck. There may also be pain when you lower the shoulder from a raised position.
Torn rotator cuff symptoms are similar to a strain, but with a tear, you may also notice weakness when lifting your arm, or a crackling sensation when you move your shoulder, Dr. Kimbrough says. Tears that happen from falling and landing on an outstretched hand, for example, often cause immediate pain and weakness.
A complete tear can make it almost impossible to move your arm. Without treatment, you may have chronic shoulder pain and find it very difficult to use your injured arm.
In shoulder bursitis, pain is usually focused around the outer side of the shoulder, while in a rotator cuff tear, the pain often extends down the arm and can be sharper, especially with certain movements.
A physical exam is the first step to diagnosing rotator cuff injuries. During the exam, a healthcare professional will press on different parts of the affected shoulder and move the arm into different positions. They'll also test the strength of the muscles around the shoulder and in the arms.
Four common symptoms
If you are dealing with rotator cuff issues, you can reduce pain by sleeping on your back rather than on your side. You can even elevate your injured shoulder in this position by placing a folded towel or pillow underneath it, reducing swelling and inflammation.
On the other hand, rotator cuff tears become more and more common with increasing age. While only 10 to 15 percent of those aged 50 to 59 might have a tear, that percentage increases with each decade, with about 50 percent of those age 80 and above having a tear.
Rotator Cuff Tears Red Flags & Signs
A very good indicator that a painful, weak shoulder has a rotator cuff tear, is the inability to sleep at night due to the pain. This often means that surgery should be a consideration for treatment. One simple well-known test to check for a torn rotator cuff is the “drop-arm” test.
How long does it take for a torn rotator cuff to heal without surgery? For minor tears, healing can take 6 to 12 weeks with a combination of physical therapy, medication and lifestyle modifications. More severe tears may take several months to heal and might not fully heal without surgery.
Rotator cuff injuries commonly cause pain and tenderness in the front or side of the shoulder: You may have pain and stiffness when you try to lift your arm and reach for things above your head. There may also be pain when bringing your arm down. The pain is typically at its worst at night.
The rotator cuff is a group of muscles and tendons that surround the shoulder joint. These muscles keep the ball of the upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder that worsens at night.
The first stage of bursitis is when the bursa gets inflamed. This can happen due to injury, infection, or too much movement. Symptoms include pain, swelling, and trouble moving the affected area. It's important to act early to stop it from getting worse.
Shoulder impingement syndrome has very similar symptoms to a rotator cuff tear, which is why people often mistake the two.
Those are small to medium tears. Patients still have the ability to raise their arm, and they can still do day-to-day things, but they tend to have some pain. So, being able to use the arm and move it and raise it above your head does not necessarily mean that the rotator cuff is intact.
You may have pain in the shoulder when you lift your arm, or pain that moves down your arm. There may also be no symptoms. At first, the pain may be mild, and you may feel it only when lifting your arm over your head, such as reaching into a high cabinet.
If you have symptoms that don't get better after 3 to 6 months, you may need surgery. You may want to think about surgery if you have torn your rotator cuff in a sudden injury and the tear is causing shoulder weakness.
Tears that develop slowly over time can also cause pain and weakness in your arm/shoulder. You may first notice pain when you lift your arm overhead. The longer you live with a slowly developing tear, the more discomfort you'll feel, specifically while at rest.
A torn rotator cuff does not always require an MRI. Many people assume advanced imaging is essential, yet physiotherapists can often identify the likely tendon injury through clinical assessment alone. Strength tests, movement analysis and pain behaviour patterns all provide valuable information.
What are the symptoms of a rotator cuff tear or tendonitis? Tendonitis pain and chronic rotator cuff tendon pain can be gradual and can worsen overtime with continued use of the shoulder joint. In contrast, an acute rotator cuff tear will typically present with sharp, immediate pain and weakness in the shoulder joint.