Rotator cuff tear

Rotator cuff is made of four muscles namely – supraspinatus, infraspinatus, subscapularis and teres minor. All these muscles form a group and are attached to the greater and lesser tuberosity and help in movements  around the shoulder especially abduction and external rotation.


  1. Injury, especially while trying to lift or catch a heavy object
  2. Overuse, especially after a period of inactivity
  3. Poor blood supply to an area of the cuff (which occurs with increasing age)
  4. A fall on an outstretched arm
  5. A gradual weakening of the tendons of the shoulder, often associated with impingement


After a cuff tear, the patient is no longer able to lift or rotate his or her arm with the same range of motion as before the injury and/or has significant pain associated with shoulder motion. The pain is also very common at night, often radiating down the arm.


The diagnosis is usually confirmed by MRI which may quantify the type and amount of tear in the muscles.

Good quality X rays can help in indirect diagnosis of the pathology due to high riding humeral head.


  1. Painkillers and anti-inflammatory medications
  2. Physiotherapy – keeps your shoulder strong and flexible and reduce the pain and weakness
  3. Cortisone steroid injections  – reduces inflammation and control the pain. It is advisable to avoid repeated steroid injections in the presence of a tendon tear, as this may weaken the tendon further.
  4. PRP injections – In partial tears, PRP injections may be used , since they have been shown to have some reparative capacity as well.
  5. Surgery is required –
    a. If the tear follows an injury
    b. When pain and weakness is not improved with injections and physiotherapy
    – The goal of any surgery is to relieve the pain and improve the shoulder strength. This requires a long period of physiotherapy in addition to the surgery.
    – Surgery may be done Arthroscopically (keyhole) or Open, or a combination of the two, known as a Mini-repair.