Rotator Cuff
What is the Rotator Cuff?
Simple activities like combing your hair or reaching behind your back can be impossible when you have a rotator cuff issue such as a tear.
The rotator cuff is a group of muscles and tendons that surrounds and stabilises the shoulder joint. These tendons are important for moving your shoulder joint. A rotator cuff problem can cause either a dull or sharp ache in the shoulder, which worsens if you try to lift your arm up.
Causes of Rotator Cuff Tear
Rotator cuff injury may be the result of either a substantial injury to the shoulder or progressive degeneration of the tendon tissue. Repetitive overhead activity or heavy lifting over a prolonged period of time may irritate or damage the tendon.
A very common condition that develops in the 20s to 40s is Impingement. This refers to the tendon being rubbed by the overlying bone. Impingement causes episodic pain in certain positions, for example when putting on clothes or when sleeping on the shoulder.
Many people experience Impingement symptoms but do not realise its significance. When left untreated, it may lead to Rotator Cuff Tear. When a Rotater Cuff Tear is itself left for some time, the patient may develop Arthritis of the shoulder, which is wear-and-tear of the cartilage.
Symptoms & Risk Factors
Symptoms
The pain associated with a rotator cuff injury may:
Be described as a dull ache deep in the shoulder, or a sharp pain in certain positions
Disturb sleep
Make it difficult to comb your hair or reach behind your back
Be accompanied by arm weakness
Risk Factors:
Age. As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears are most common in people older than 60.
Activity. Repetitive overhead activities such as lifting weights may be a risk factor for Rotater Cuff Injuries. Occupations such as carpentry or house painting require repetitive arm motions that may also be risk factors.
Family history. There may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in certain families.
Accurate diagnosis is one of the most important steps
in developing a customised & effective treatment plan.
Rotator Cuff Tear Diagnosis
See the doctor right away if you have immediate weakness in your arm after an injury.
During the physical examination, the doctor will press on different parts of your shoulder and move your arm into different positions. He will also test the strength of the muscles around your shoulder and in your arms.
In some cases, he may recommend imaging tests, such as:
X-rays. Although a rotator cuff tear won’t show up on an X-ray, this test can visualize bone spurs or other potential causes for your pain — such as arthritis.
Magnetic resonance imaging (MRI). This scan uses magnetic waves to obtain images of the internal parts of the shoulder in great detail.
Rotator Cuff Tear Treatment
Conservative treatments — such as rest, ice and physiotherapy — sometimes are all that is needed to recover from a rotator cuff injury. However, this is usually for milder cases.
Therapy
Physiotherapy is a basic treatment that involves exercises tailored to the specific location of your rotator cuff injury. In appropriate cases, therapy can help restore flexibility and strength to your shoulder. Physiotherapy is also an important part of the recovery process after rotator cuff surgery.
Injection
If conservative treatments haven’t reduced your pain, the doctor might recommend an injection into your shoulder joint, especially if the pain is interfering with your sleep, daily activities or physiotherapy.
Shoulder Scope Procedure
For more severe cases, a Key-Hole Tendon Repair procedure may be required. This procedure is performed using just small cuts on the skin and aims to reattach the torn tendon to the bone. In severe cases, this is the most effective way to remove pain, restore shoulder movement, and prevent progression to arthritis.
Frequently Asked Questions
Find quick answers to common queries, designed to help you navigate
your orthopaedic care journey with ease.
You can come see us without having to obtain any referral letters first.
The exception is if you are using a corporate insurance plan, as some corporate insurers require you to see a family doctor on your panel first, and ask for a referral letter to us.
Yes, but it can take one to three years without treatment. Early intervention shortens recovery and reduces the severity of your symptoms. Some patients are left with residual stiffness even after the condition resolves.
Starting frozen shoulder treatment early gives you the best chance of a faster recovery. For most patients, a corticosteroid injection combined with physiotherapy offers the most effective improvement. In more advanced cases, hydrodilatation or arthroscopic release may be more appropriate.
Yes, physiotherapy is one of the main pillars of frozen shoulder treatment. A structured programme of manual therapy and stretching can meaningfully improve range of motion, particularly in the frozen and thawing stages. How consistently you do your home exercises plays a significant role in how quickly you recover.
If your shoulder has been stiff or painful for more than two to three weeks without improvement, get it assessed. Night pain, difficulty reaching behind your back, or restricted overhead movement all warrant specialist review. People with diabetes or thyroid conditions should seek assessment promptly.
Yes. A corticosteroid injection reduces inflammation and pain, making physiotherapy more effective. Hydrodilatation is another option for patients who have not responded to standard injections alone.
Frozen shoulder surgery is considered when pain persists for several months and conservative treatments have not produced adequate improvement. Arthroscopic capsular release is a keyhole procedure that removes the thickened tissue restricting your shoulder. Most patients experience meaningful improvement in pain and mobility in the weeks that follow.
Recurrence in the same shoulder is uncommon. However, some patients develop it in the other shoulder at some point. The second episode does not always follow the same severity or timeline as the first.
Centurion Orthopaedic Centre
38 Irrawaddy Road
Mt Elizabeth Novena Hospital Specialist Centre #07-40
Singapore 329563