What does rotator cuff tear mean in older adults?

The rotator cuff is a group of tendons that helps keep the upper arm centred in the shoulder and allows lifting, reaching and rotation. A tear may develop gradually as tendon tissue becomes less resilient, or it may follow a fall or sudden load. Symptoms can include aching, night discomfort, reduced reach and difficulty lifting the arm. The amount of pain does not always match the size of the tear, so an examination is more useful than judging the problem by pain alone.

Arrange an assessment if shoulder pain or weakness is interfering with dressing, washing, sleep or everyday reaching. A clinician may test movement and strength and decide whether imaging would clarify the tendon or another shoulder problem. Treatment can include activity adjustment, pain relief chosen with a clinician, and a gradual rehabilitation programme to preserve movement and strengthen suitable muscles. Some tears are managed without surgery; the choice depends on symptoms, function, the injury pattern and general health.

Seek prompt medical care after a fall or sudden injury if the arm cannot be lifted, the shoulder looks abnormal, or weakness appeared immediately. Arrange medical review for persistent night pain, increasing weakness, swelling, redness, fever or pain that is worsening rather than settling. Sudden chest symptoms, breathlessness or pain spreading beyond the shoulder require emergency attention.

Ask which tendon appears affected, whether the tear seems new or longstanding, what movements should be limited, and how rehabilitation will be progressed. You can also ask what findings would make an injection, specialist opinion or surgery worth discussing.