How Do You Know If Your Rotator Cuff Is Torn?
- Matthew Barrett
- Jun 30
- 3 min read
If you’ve been dealing with ongoing shoulder pain, especially when lifting your arm or reaching behind your back, it’s natural to wonder, "Could I have torn my rotator cuff?"
As a shoulder surgeon and specialist, this is one of the most common questions I hear in the clinic. And while not every sore shoulder means there’s a tear, there are a few signs that can point us in that direction, so let's explore them.
Contents:
First of All: What Is the Rotator Cuff?
The rotator cuff is a group of four small muscles and their tendons that help stabilise your shoulder and allow you to lift, rotate, and reach. They’re working constantly; whether you’re putting on a jacket, brushing your hair, or reaching up to a cupboard, yep, they're hard at work! And because these muscles are involved in so many everyday movements, they can become irritated, inflamed, or, in some cases, torn.
Signs You Might Have a Rotator Cuff Tear
One of the biggest red flags is weakness, especially if it comes on suddenly or is affecting movements that were previously easy. You might notice:
Pain when lifting your arm overhead, especially above shoulder height
A dull ache in the side of the shoulder, sometimes radiating down the upper arm
Difficulty with movements like reaching behind your back or fastening a bra
Shoulder weakness, particularly during activities like reaching, lifting, or carrying
Pain at night, particularly when lying on the affected side
In more significant tears, patients often describe the shoulder feeling “not quite right” as if it’s lost its usual strength or control. In smaller or partial tears, the signs can be more subtle, with pain only appearing during certain movements or after activity.
Do All Rotator Cuff Tears Need Surgery?
Not at all. Many people worry that a rotator cuff tear automatically means surgery, but that’s not always the case and usually the last resort.
Partial tears or tendon irritation can often be managed with rest, physiotherapy, and sometimes a corticosteroid injection to settle inflammation and support recovery. The goal is to reduce pain, strengthen the surrounding muscles, and restore function so that you can get back to doing what you love, pain-free.
Full-thickness tears or larger injuries may benefit from surgical repair, especially in younger patients, active individuals, or those whose symptoms are limiting daily life. The key is understanding the extent of the tear, how it’s affecting your shoulder, and what treatment will give you the best outcome.
How Can I Be Sure If It’s Torn?
The only way to know for certain is through a clinical assessment. I’ll usually start by asking about your symptoms, examining your shoulder movement and strength, and checking for specific signs that point toward a tear.
If needed, we can arrange an MRI or ultrasound scan, which gives a clear view of the rotator cuff tendons and helps guide treatment decisions.
It’s all about understanding what your shoulder needs. That could be a series of rehab, an injection, or, in some cases, surgery, as I have mentioned.
If you’ve noticed ongoing shoulder pain, especially when reaching overhead or behind your back, or your shoulder feels weaker than usual, it’s worth getting checked. A torn rotator cuff is a common injury, and with the right treatment, most people make a strong recovery.
I see patients with shoulder pain every week across my private clinics in Poole and Dorchester, Dorset, and helping people get back to their best is what it’s all about.
If your shoulder isn’t doing what it used to, don’t wait to see if it'll improve. Let’s figure out what’s going on and build a plan to get you moving again.