Rotator cuff tear: Signs and symptoms of this serious shoulder injury

Rotator cuff injuries represent a spectrum of conditions that can vary in severity from impingement of the tendons to a partial-thickness tear to full-thickness rotator cuff tear. This article discusses some of the common signs and symptoms affected patients might experience with rotator cuff tears or impingement.

Pain when reaching overhead

Rotator cuff injuries can cause pain with most activities, but typically they cause pain in certain positions. Frequently a patient complains of pain with overhead activities. Examples include pain when she reaches into cabinets or lifts her arm to comb her hair.

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Pain reaching out away from the body

Similar to reaching overhead, a patient might specifically notice pain reaching out away from her body, especially at or above shoulder level. A common example would be pain the patient feels as she lifts a carton of milk out from a refrigerator.

Pain reaching behind the back

Rotator cuff injuries often cause problems when the patient tries to reach behind her back. Often the problem is pain in addition to loss of motion. She might notice pain specifically when tucking in her shirt or fastening her bra strap.

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Decreased or limited shoulder motion

A patient might notice loss of shoulder motion even before the shoulder becomes painful. Often she notices decreased motion in certain directions. For example, she might notice difficulty reaching behind her back, such as with tucking in a shirt, caused by loss of shoulder internal rotation. Difficulty getting the arm above shoulder level can develop as well.

Shoulder pain at night

Night pain of the shoulder and upper arm is not unique to rotator cuff injuries, and not every patient with a rotator cuff disorder experiences night pain. However, it is a common reason patients say that they finally decide to see a physician, even if they have had shoulder problems for months. Often the pain increases late at night, prevents the patient from falling asleep, or wakes her up frequently.

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Shoulder impingement

This list is not comprehensive by any means. Also a patient can have only one or a few of these symptoms with a rotator cuff injury. If these or other shoulder complaints are limiting someone with exercise, work or daily activities, she should consider seeing an orthopedic surgeon.

Illustration of rotation cuff tear