Rotator cuff injury is an inflammation or tear in the tendons of the rotator cuff, the group of muscles and tendons that forms, in part, the covering around the shoulder joint. The muscles of the rotator cuff make it possible to lift and rotate the arm, and when the tendons are repeatedly stressed or torn, shoulder pain occurs and mobility of the arm becomes limited.

In rotator cuff tendinitis, the humerus or long bone of the upper arm, rubs against a tendon causing microscopic tears and inflammation. In rotator cuff tear, a more serious injury, a rupture of a tendon from the bone causes severe pain and may severely limit arm movement. Recovery from a rotator cuff injury depends on whether a tendon is inflamed or whether it is actually torn from the bone.

What Causes Rotator Cuff Injury?

  • Repeated stress to the shoulder from activities such as sports or heavy labor.
  • Trauma to the shoulder, such as falling on an outstretched arm or lifting heavy objects
  • Wearing out the shoulder by years of continual use, usually occurring between the ages of 60 and 75

Symptoms of Rotator Cuff Injury

  • Tenderness in the shoulder region, often worse at night
  • Failure to lift or rotate the arm
  • Snapping noise or crackling sensation when moving the shoulder in certain positions
  • Inability to abduct your arm (raise it out to the side) without assistance if there is a severe tear
  • Pain aggravated by rotating or lifting the arm, especially to an angle of 90 degrees or higher.
  • Sudden, sharp pain in the shoulder that radiates toward the elbow
  • Pain and weakness in the shoulder that lasts several months or longer despite treatment


  • Exercises that increase strength and flexibility of the rotator cuff muscles will reduce the risk of injury.
  • Avoid activities that cause shoulder soreness.

Diagnosis of Rotator Cuff Injury

  • Physical examination may include range of motion tests to determine the extent of injury. A mild tear is most painful when the arm is raised between 70 and 120 degrees; a complete tear may render the arm incapable of being raised above the head.
  • Arthrography (an x-ray technique using dye injection), MRI (magnetic resonance imaging) or ultrasound may be used to examine joint tissues.

How to Treat Rotator Cuff Injury

  • Ice the shoulder daily or after exercise.
  • Take over-the-counter pain relievers such as aspirin, acetaminophen, ibuprofen or naproxen.
  • Range of motion exercises are recommended as soon as possible after an injury to prevent a frozen or stiff shoulder. Wearing a sling to partially immobilize the shoulder may also be recommended, but for no longer than a few days. Some patients may benefit from physical therapy exercises to strengthen the rotator cuff muscles.
  • If the above measures fail, a cortisone injection into the area of the tendon may reduce pain and inflammation.
  • Surgery may be necessary for a torn tendon and for cases that do not respond to other treatments.

When to Call a Doctor

  • Call a doctor if routine motions such as lifting your arm to comb your hair become difficult and painful or if you experience severe pain after trauma to the shoulder.


Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference

Simeon Margolis, M.D., Ph.D., Medical Editor

Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Updated by Remedy Health Media

Publication Review By: the Editorial Staff at

Published: 29 Aug 2011

Last Modified: 26 Feb 2015