What Are the First Signs of a Rotator Cuff Tear?

The rotator cuff is a group of tendons and muscles that stabilise and move the shoulder. A tear may follow a fall, a sudden lifting effort, or gradual tendon wear. Pain can be felt at the outer shoulder and may spread down the upper arm. Weakness may be more noticeable than pain when reaching into a cupboard, fastening clothing, or lifting the arm away from the body. Some people notice pain at night or difficulty lying on the affected side. Similar symptoms can occur with tendinitis, bursitis, or stiffness, so symptoms alone cannot confirm a tear.

Avoid heavy overhead lifting and movements that cause a sharp increase in pain, but keep the elbow, wrist, and shoulder gently moving within comfort. Do not repeatedly test strength against resistance. Arrange an assessment if weakness persists or daily tasks become difficult. A clinician may examine movement and strength and decide whether imaging is useful. Treatment can include rehabilitation; injections or surgery are considered according to the tear and its effect on function.

Seek prompt assessment after a fall or sudden force if you cannot lift the arm, or if pain and weakness start abruptly. Urgent care is appropriate for a visibly deformed shoulder, severe swelling, a cold or numb hand, chest symptoms, or severe pain that is not settling.

Does my weakness suggest tendon damage or another shoulder problem? Which movements should I avoid? Would physiotherapy, an injection, or imaging be appropriate for my symptoms?