Is lifting your arm becoming a pain – literally? Rotator cuff tears are a common cause of shoulder pain, especially from our 40s onwards, according to DR KEVIN YIK from Elite Orthopaedics. Here, the orthopaedic surgeon answers a few of our questions about the condition, from how rotator cuff tears occur to what symptoms to watch out for.
What is a rotator cuff?
Think of your shoulder as a ball-and-socket joint, much like a golf ball sitting on a tee. The “ball” is the top of your upper arm bone (humerus), and the “socket” is part of your shoulder blade (scapula). Four muscles keep the ball snug in the socket, allowing you to lift and rotate your arm. These muscles (the supraspinatus, infraspinatus, subscapularis and teres minor) and their tendons – the strong cords that attach muscle to bone – are collectively known as the rotator cuff.
How do rotator cuff tears occur?
A rotator cuff tear means one or more of these tendons has been damaged. This can range from a small, partial tear to a complete tear where the tendon is fully detached from the bone.
Rotator cuff tears occur in two main ways. An acute or traumatic tear usually happens after a fall on an outstretched arm, a direct blow to the shoulder or a sudden, jerky movement like lifting something heavy. These tears are more common in younger individuals.
More often, especially in people over 40, tendons weaken and fray over years of use. This can eventually lead to a tear, sometimes without an obvious injury. This is called a degenerative tear. Repetitive or strenuous overhead movements can speed up this process. Bone spurs under the shoulder blade may also rub against the tendons, contributing to the tear.
What are the symptoms?
People with a rotator cuff tear often experience a sharp pain or dull ache in the shoulder, which may worsen when lifting or lowering the arm. The pain might start at the neck and extend down the arm. Weakness is also common and tasks like reaching behind your back or combing your hair can become challenging or painful.
How are rotator cuff tears diagnosed?
If you suspect a rotator cuff tear, see an orthopaedic specialist. They’ll ask about your symptoms and medical history and examine your shoulder’s range of motion, strength and pain level during specific movements.
Imaging tests may be ordered. While x-rays don’t show tendons, they can rule out issues like arthritis or fractures. Ultrasound can show soft tissue damage and may detect tears. MRI is the best imaging test for diagnosing rotator cuff tears. It gives detailed images of the tendons and shows the size and location of the tear.
What are the treatment options?
Treatment depends on the size of the tear, your age, activity level and overall health. The goal is to relieve pain and restore function. Many people find relief with non-surgical options such as rest, pain relief, physiotherapy and sometimes corticosteroid or platelet-rich plasma injections.
Surgery might be recommended in the case of large or complete rotator cuff tears, acute or traumatic tears in younger patients, or persistent pain and weakness that impacts daily life. Surgery reattaches the tendon to the bone, often done arthroscopically (keyhole surgery) through small incisions.
What is the recovery like?
After surgery, you’ll wear a sling for four to six weeks. Physiotherapy will begin with gentle range-of-motion exercises and progress to strengthening. Recovery may take several months. With appropriate treatment and rehab, many people return to their usual activities. If you’re struggling with rotator cuff tears or shoulder discomfort, seek medical advice early to find the best way forward.
About the doctor
Dr Kevin Yik is an experienced orthopaedic surgeon specialising in orthopaedic trauma, plus shoulder and elbow surgery, including complex fracture fixation, arthroscopy and joint replacement.
Elite Orthopaedics is at Gleneagles Medical Centre and Mount Elizabeth Medical Centre.
6312 4110 | enquiries@eliteortho.com.sg | eliteorthopaedics.com.sg
This article on why your rotator cuff keeps tearing, how rotator cuff tears occur and Elite Orthopaedics first appeared in the September 2025 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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