Rotator Cuff Tears
The shoulder is one of the most mobile joints in the body, allowing a wide range of motion for lifting, throwing, and reaching. This mobility, however, makes it vulnerable to injury—especially in the soft tissues that stabilize it. One of the most common shoulder injuries is a rotator cuff tear, a condition that can cause significant pain, weakness, and limited motion. Dr. Kevin Collon, an orthopedic surgeon at Keck Medicine of USC, is fellowship-trained in sports medicine and specializes in diagnosing and treating shoulder injuries, including rotator cuff tears, for patients in Los Angeles, CA.
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint. These muscles work together to stabilize the head of the upper arm bone (humerus) in the shallow socket of the shoulder blade (glenoid) and to assist with raising and rotating the arm. When one or more of these tendons is torn, either partially or completely, the shoulder loses some of its strength and stability, leading to pain and difficulty performing normal daily activities.
A rotator cuff tear occurs when one of the tendons detaches from the bone. Tears can range in severity from small partial-thickness tears—where the tendon is damaged but not completely severed—to full-thickness or complete tears, where the tendon is torn all the way through. In some cases, the tendon may completely detach from the bone, leaving a gap between the tendon and its attachment site.
These tears can occur suddenly from an injury, such as lifting a heavy object or falling on an outstretched arm, or they may develop gradually over time due to wear and tear from repetitive motions or age-related degeneration.
Rotator cuff tears can cause a wide variety of symptoms, ranging from mild discomfort to severe shoulder dysfunction. Common signs and symptoms include:
- Pain at rest and during certain movements, especially when lifting or lowering the arm
- Weakness when lifting or rotating the arm
- A crackling or popping sensation when moving the shoulder
- Difficulty sleeping on the affected side due to pain
- Limited range of motion or stiffness in the shoulder
Some individuals may experience a sudden tearing sensation or snapping feeling in the shoulder followed by sharp pain, especially if the tear occurs from an injury. Chronic tears, on the other hand, tend to cause a gradual increase in discomfort and weakness over time.
Rotator cuff tears generally occur from two main causes: acute injury or chronic degeneration.
- Acute tears are usually the result of trauma. These can happen from falling on an outstretched hand, lifting something heavy with a jerking motion, or experiencing a direct blow to the shoulder. This type of injury is more common in younger or active individuals, such as athletes or those with physically demanding jobs.
- Degenerative tears develop gradually as the tendons wear down over time. The blood supply to the rotator cuff decreases with age, making it harder for the tendons to heal from minor injuries. Repetitive shoulder movements—such as those involved in overhead sports (tennis, baseball, swimming) or occupations (painting, construction)—can also contribute to degeneration. Poor posture and bone spurs on the acromion (the bony top of the shoulder blade) may further increase friction and stress on the tendons, eventually leading to tears.
Several factors increase the risk of developing a rotator cuff tear.
- Age is one of the most significant factors; people over 40 are more prone to degenerative tears.
- Repetitive overhead activities in sports or work, such as baseball, tennis, swimming, or carpentry, can also contribute to wear and tear.
- Poor shoulder mechanics or posture can place additional strain on the rotator cuff tendons.
- Individuals with a family history of rotator cuff injuries, smokers, or those with reduced circulation to the shoulder region may have a higher risk as well.
- In athletes, inadequate warm-up, muscle imbalances, and improper technique can predispose the shoulder to injury.
Diagnosis begins with a detailed history and physical examination. Dr. Collon will evaluate shoulder strength, range of motion, and pain patterns to determine which tendons may be involved. Imaging studies are often used to confirm the diagnosis. X-rays help rule out bone abnormalities, while MRI or ultrasound imaging provides detailed views of the soft tissues, revealing the size, location, and severity of the tear.
Early diagnosis is important because untreated tears can enlarge over time and lead to muscle atrophy, chronic pain, and shoulder stiffness. Identifying the problem early helps guide appropriate treatment and improves long-term outcomes.
Untreated complete tears can lead to rotator cuff arthropathy, a form of shoulder arthritis caused by chronic tendon damage. Additionally, untreated tears may cause compensatory strain on other parts of the shoulder, increasing the risk of secondary injuries.
Because the rotator cuff plays a vital role in nearly every shoulder movement, persistent damage can affect daily activities such as dressing, lifting, driving, or even sleeping comfortably. Early evaluation and management are essential to restore normal movement and prevent long-term disability.
If you are experiencing shoulder pain, weakness, or difficulty lifting your arm, don’t ignore the symptoms. Early diagnosis and expert treatment can help prevent further damage and restore function. Schedule a consultation with Dr. Kevin Collon, fellowship-trained orthopedic surgeon in sports medicine at Keck Medicine of USC in Los Angeles, to learn more about your options for recovery and get back to the activities you love. Call today or visit the Keck Medicine website to request an appointment.
At a Glance
Dr. Kevin Collon
- Fellowship-Trained Sports Medicine Surgeon
- Team Physician – LA Kings, USC Athletics
- Cutting-edge, Evidence-based Treatment
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