Rotator Cuff Tears

Tearing of the shoulder tendons that can cause pain, weakness, and loss of movement

The rotator cuff is a group of four muscles and tendons that surround the shoulder joint. Together, they play a critical role in stabilising the shoulder and allowing smooth, controlled movements like lifting, reaching, and rotating the arm. A rotator cuff tear occurs when one or more of these tendons are partially or completely torn away from the bone, usually due to injury, overuse, or degeneration over time.

Rotator cuff tears are a common cause of shoulder pain and dysfunction, especially in people over 40 or those involved in repetitive overhead activities. Tears can be acute, resulting from trauma such as a fall, or chronic, developing gradually due to age-related tendon wear.

In the following sections, you’ll learn what a rotator cuff tear is, how it happens, common symptoms to watch for, and the different options available to manage and treat it. Whether your tear is the result of an injury or gradual wear and tear, understanding the nature of your condition is the first step toward informed, confident treatment decisions.

What is a rotator cuff tear?

The rotator cuff is a group of four muscles and tendons that stabilise your shoulder joint and allow you to lift, rotate, and control arm movements. These muscles originate from the shoulder blade and insert into the top of the humerus (upper arm bone), forming a cuff around the joint.

A rotator cuff tear occurs when one or more of these tendons becomes damaged or detached from the bone. Tears can be partial (where the tendon is frayed or damaged) or full-thickness (where the tendon is completely torn away). These injuries can result from acute trauma (such as a fall or lifting injury) or develop gradually due to age-related degeneration and wear-and-tear.

Common causes of rotator cuff injury

Rotator cuff tears are commonly caused by either:

Other contributing factors include:

As the tendon tissue wears down with age or use, it becomes more vulnerable to tearing—even with relatively minor movements.

Recognising the symptoms of a rotator cuff tear

Rotator cuff tears may cause a range of symptoms, which can be sudden or develop gradually. Common signs include:

Pain at the front or side of the shoulder, often worse at night
Weakness in the shoulder or arm, especially when lifting or reaching overhead
Limited range of motion and difficulty with everyday tasks such as dressing or lifting
Clicking, catching, or grinding during arm movement
Pain when lying on the affected shoulder

In more chronic cases, the pain may initially be mild but become more noticeable over time as the tear enlarges or function declines.

How is a rotator cuff tear diagnosed?

Dr Jason Hockings will perform a thorough clinical assessment to evaluate your shoulder and determine whether a rotator cuff tear may be present. This includes:

A review of your medical history and symptom pattern

A physical examination of your shoulder's range of motion, strength, and stability

Special tests to assess for tendon involvement

Imaging is often used to confirm the diagnosis and guide treatment planning:

X-rays can identify bone spurs or rule out arthritis

Ultrasound is a useful tool to visualise tendon tears in real time

MRI provides a detailed view of the rotator cuff tendons, showing the size, location, and severity of the tear, as well as any associated muscle damage

Do all rotator cuff tears need surgery?

Not all rotator cuff tears require surgery. The decision to operate depends on a range of factors, including:

The size and location of the tear

Whether the tear is partial or full-thickness

The level of pain and functional limitation

The patient’s age, activity level, and overall health

Whether the symptoms improve with non-surgical treatment

Many partial tears and some full-thickness tears can be successfully managed without surgery—especially in older patients or those with lower activity demands.

Non-surgical treatment options

Non-surgical treatment may help relieve pain and restore function in patients with small or degenerative rotator cuff tears. Options include:

Physiotherapy: A structured program to strengthen the surrounding shoulder muscles, improve posture, and support joint movement

Activity modification: Avoiding movements that aggravate the shoulder

Anti-inflammatory medications: To reduce pain and swelling

Corticosteroid injections: May provide short-term relief for inflammation and pain, particularly to support physiotherapy progress

Dr Hockings will work with you to decide whether a non-operative pathway is appropriate and review your progress closely over time.

What does rotator cuff repair surgery involve?

If surgery is recommended, Dr Jason Hockings typically performs an arthroscopic rotator cuff repair. This is a minimally invasive procedure that uses small incisions and a camera-guided instrument (arthroscope) to access and repair the damaged tendon. The torn tendon is cleaned, stitched, and anchored back to the bone using tiny implants known as suture anchors. This technique is designed to preserve the surrounding tissue and generally results in less post-operative discomfort and a faster recovery than traditional open surgery.
In some cases, additional procedures may be carried out during the same operation to improve shoulder function, such as relieving impingement by removing bone spurs (subacromial decompression), or addressing issues with the biceps tendon. Surgery is usually performed as a day procedure under general anaesthetic, and your recovery will be supported by a carefully structured physiotherapy program to restore movement, strength, and shoulder stability over time.
Whether your tear is best treated with physiotherapy or requires surgical repair, Dr Hockings is committed to helping you regain shoulder strength, mobility, and confidence.

If you’re experiencing ongoing pain, stiffness, or reduced movement that is affecting your daily activities or quality of life, a thorough orthopaedic assessment can help determine the cause and guide the most appropriate treatment options for your situation.

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