Is rotator cuff tear safe in older adults?

The rotator cuff is a group of tendons that helps lift and rotate the shoulder. A tear may follow an injury, or develop gradually as the tendon becomes less able to tolerate load. Some tears cause little discomfort, while others produce night pain, weakness, or difficulty reaching overhead, dressing, or lifting a cup.

Age alone does not decide whether treatment should be active rehabilitation, activity modification, an injection, or surgery. A clinician considers the tear pattern, strength, movement, pain, general health, goals, and how much the shoulder affects independence.

Arrange an examination if shoulder pain or weakness persists, especially after a fall or sudden pulling injury. Until then, avoid movements that sharply increase pain and keep the elbow, wrist, and shoulder moving gently within a comfortable range. Do not completely immobilise the arm unless a clinician has advised it.

A physiotherapist can help preserve movement and build shoulder-blade and arm strength gradually. Tell the clinician about diabetes, blood-thinning medicines, previous shoulder problems, and any difficulty managing at home.

Seek urgent medical help after a major injury if the shoulder looks deformed, the arm is numb or cold, or you cannot move it. Arrange prompt assessment for rapidly increasing swelling, severe unrelenting pain, fever, or new weakness that prevents basic tasks. These features need evaluation rather than being attributed to age or a known tear.

Ask which tendon is affected, whether the weakness matches the tear, what movements to avoid, and whether an examination or scan is needed. Also ask how rehabilitation will be paced and which changes should trigger an earlier review.