If you’ve had shoulder pain for a while now, you may wonder “how do I know if my rotator cuff is torn?” It’s natural to ask yourself this – 65% of people with rotator cuff tears don’t even know they have it. (1)
Well, there are 5 tell-tale signs you can watch out for, including painful clicking sounds or specific muscle weakness. All will be discussed in detail further down.
Here’s an overview of what you’ll find here. Tap on any of these topics to jump into their sections:
- Sign 1 – Mechanism of injury
- Sign 2 – Shoulder crepitus
- Sign 3 – Muscle weakness
- Sign 4 – Limited range of motion
- Sign 5 – Shoulder pain at night
- How rotator cuffs injuries are diagnosed
- Quick tips for healing a rotator cuff tear
Or keep reading to learn the:
5 Tell-tale signs of a rotator cuff tear
1) Think about the moment symptoms started
Your recent history can help tell if you suffered from a shoulder injury. And, with a torn rotator cuff, the mechanism of injury can happen in two ways:
Two of the most common ways to injure your rotator cuff are (2):
- Catching yourself when you fall on your outstretched hand (51%)
- Carrying a heavy object (24%)
Also, a sudden, strong muscle contraction to counteract resistance can result in acute tendon tears.
You may start to notice immediate weakness and significant pain after the incident, which can indicate a rotator cuff injury.
Overuse injuries are a result of microtrauma to your rotator cuff tendons. Here are a few common examples of how these injuries happen:
- Repetitive overhead activities, such as doing tennis serves and playing volleyball
- Older age, as our tendon resiliency weakens as we grow older
Without proper rest and recovery, this wear and tear can lead to tendon degeneration and, eventually, a torn rotator cuff.
2) Constant shoulder clicking/popping
These noises – called crepitus – aren’t inherently bad. But, if you notice they increased, or if they suddenly become painful, that can be a sign of a rotator cuff tear.
See, if you have a rotator cuff injury, moving your arm won’t be as smooth as it was because the stability of your shoulder joint is compromised. Thus, leading to joint crepitus and possibly pain.
3) Muscle weakness
Are you hiking your shoulders just to lift your arm?
Because if you are, that could be another sign of a rotator cuff problem.
These muscles are among your shoulder’s prime movers. Therefore, rotator cuff injuries could force you to exert more effort just to lift your arm.
As a matter of fact, shrugging your shoulders when you lift your arms to 90 degrees has been used to diagnose rotator cuff injuries. (3)
4) Limited range of motion on your shoulder
Loss of range of motion is often caused by pain, weakness, and suboptimal shoulder mechanics. So, if you find it’s more difficult to reach for objects that are far from you, it could be a sign of a rotator cuff tear.
But this isn’t a bad thing. Think of the limited range of motion as your body’s way of protecting your joint from more harm.
The more you move your shoulder, particularly in the first stages of your rotator cuff tear, the higher the risk of doing more damage.
5) Shoulder pain at night
Is your shoulder pain starting to affect your sleep pattern? Rotator cuff injuries can make it difficult to sleep. That’s largely because shoulder pain tends to worsen at night.
There are a few factors that cause this:
- Inflammation build-up through the day
- A significant drop of cortisol levels, an anti-inflammatory hormone, at night
- Poor body alignment and tendency to sleep on your injured side
This can help: Tips to ease rotator cuff pain before sleeping
How are rotator cuff tears diagnosed?
Your doctor will test for your shoulder tenderness, range of motion, and muscle strength. Additionally, he/she will also perform a series of tests to check the integrity of your rotator cuff tendons.
To get a better look at your shoulder, your doctor may also request these tests (4):
- MRI or Ultrasound – To accurately tell if it’s a partial tear or a complete tear
- Arthroscopy – This is the gold standard to diagnosing and repairing rotator cuff tears
How do I get my rotator cuff better?
- Shoulder immobilization using a sling to avoid more harm
- Ice and pain medications to relieve pain and inflammation
- Undergo physical therapy to improve your shoulder function
- Severe tears and unstable shoulder joints might require rotator cuff repair
What is the prognosis for people who have a rotator cuff injury?
Rotator cuff injuries get worse if you don’t receive any treatment. It can feel impossible to sleep pain-free or even move your arm properly without medical care.
If you do plan to get it treated, it can take anywhere between 4-6 months of rehabilitation for a full recovery. While a minimum of 6 months is the expected recovery time after rotator cuff surgery. (5)
Can a torn rotator cuff heal on its own?
It’s unlikely. You need to undergo physical therapy or surgery to gain function back in your shoulder.
Learn more: Why it’s hard for a rotator cuff tear to heal naturally
Can poor posture be a cause of rotator cuff tear?
It can be. 65% of those who have a slouched posture are found to have a rotator cuff tear. (6)
Do rotator cuff tears affect both shoulders?
Yes, but your dominant arm has a higher chance of getting injured.
To summarize, you are likely to have a torn rotator cuff if you have:
- A history of shoulder trauma or overuse
- Clicking or snapping sounds are more frequent and painful than before
- Compensatory movements such as shoulder shrugging
- Difficulty moving your arms
- Presence of shoulder pain at night
If you have most of these signs and symptoms, please visit your doctor or physical therapist. They can address any rotator cuff problems you might have.
- Minagawa, Hiroshi et al. “Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village.” Journal of orthopaedics vol. 10,1 8-12. 26 Feb. 2013, doi: 10.1016/j.jor.2013.01.008
- Mall, Nathan A et al. “An evidenced-based examination of the epidemiology and outcomes of traumatic rotator cuff tears.” Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association vol. 29,2 (2013): 366-76. DOI: 10.1016/j.arthro.2012.06.024
- Jia, Xiaofeng et al. “Clinical evaluation of the shoulder shrug sign.” Clinical orthopaedics and related research vol. 466,11 (2008): 2813-9. doi: 10.1007/s11999-008-0331-3
- Chawla, Anirudh. (2017). Ultrasound, MRI and Arthroscopic Correlation of Rotator Cuff Tears. International Journal of Contemporary Medical Research. 4. 650. https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_1336_march_32.pdf
- Manaka, Tomoya et al. “Functional recovery period after arthroscopic rotator cuff repair: is it predictable before surgery?.” Clinical orthopaedics and related research vol. 469,6 (2011): 1660-6. doi: 10.1007/s11999-010-1689-6
- May T, Garmel GM. Rotator Cuff Injury. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547664/