Rotator Cuff Tear and Injury

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UT Southwestern Medical Center is ranked the No. 1 hospital for orthopedic care in Dallas-Fort Worth and among the best nationally by U.S. News & World Report.

Rotator cuff injuries can cause shoulder pain and limit movement in people of all ages and activity levels.

Orthopedic and sports medicine specialists at UT Southwestern Medical Center offer an outstanding level of care to evaluate and treat rotator cuff injuries, including rotator cuff tears. Our leading-edge nonsurgical and surgical care restores shoulder strength and mobility, helping patients enjoy their best health.

Rotator cuff MRI — MRI of the shoulder, showing a rotator cuff tear. This imaging helps us evaluate the tendons and surrounding structures of the shoulder.

What Is a Rotator Cuff Injury?

The rotator cuff keeps the upper arm bone in the shoulder socket. It includes a group of muscles that come together as tendons that hold the bones of the shoulder joint together. When tendons are irritated, inflamed, or torn, patients experience pain and have problems moving their arms.

Rotator cuff problems can happen suddenly – such as when falling, lifting heavy items, or making a quick pass during a basketball game – or gradually over time from wear and tear. Problems range from mild tendon inflammation to complete tendon tears.

Active adults – as well as high school, college, and other elite athletes – participating in overhead sports such as baseball, softball, tennis, and swimming can experience rotator cuff injuries. UT Southwestern’s orthopedics and sports medicine specialists evaluate and treat rotator cuff injuries in patients of all ages.

What Are the Types of Rotator Cuff Injuries?

Common rotator cuff injuries include:

Torn rotator cuff: A partial or complete tear of a tendon, often of the supraspinatus muscle at the top of the shoulder
Tendinitis: Inflammation of the rotator cuff tendons, frequently caused by repetitive overhead activity
Bursitis: Swelling of the bursa sac between the rotator cuff and shoulder bones, caused by the bones and muscles rubbing against the sac repeatedly

Why Choose UT Southwestern to Treat a Rotator Cuff Injury?

We’re skilled in evaluating and treating rotator cuff injuries and have extensive experience with all types of shoulder injuries.

We offer the most advanced technologies and techniques, such as high-resolution MRI and ultrasound, to precisely assess tendon damage.
Our surgeons perform minimally invasive arthroscopic repairs as well as complex reconstructions and tendon transfers when needed.
Our rehabilitation specialists design personalized therapy programs to restore shoulder strength and prevent injury.
Our orthopedic surgeons are trusted by athletes throughout North Texas. Our experience working with professional athletes helps us better treat all levels of active patients, whether they’re varsity and collegiate athletes, highly competitive amateurs, or patients who have injured themselves doing day-to-day activities.

What Are the Symptoms of a Rotator Cuff Injury?

People with a rotator cuff injury may notice:

A dull ache or pain deep in the shoulder
Pain that worsens when lifting or lowering the arm
Weakness in the affected arm
Limited range of motion or stiffness
Night pain that interferes with sleep, especially when lying on the affected side
Clicking or popping sensations when moving the arm

What Causes a Rotator Cuff Injury?

Rotator cuff injuries can result from:

Repetitive overhead motion, such as throwing, painting, or lifting
Trauma, including falls or heavy lifting
Age-related wear and tear that weakens tendon fibers
Poor posture or muscle imbalance that alters shoulder mechanics
Bone spurs that rub against the tendon and cause irritation

How Are Rotator Cuff Injuries Diagnosed?

Our shoulder specialists begin with a thorough physical examination and discussion of the symptoms and activity level. Diagnostic tools may include:

Imaging studies such as X-rays, MRI, or ultrasound to evaluate bone structure, tendon integrity, and inflammation
Strength and range-of-motion tests to identify muscle weakness or instability
Diagnostic injections that can help confirm whether pain originates from the rotator cuff or another part of the shoulder

How Are Rotator Cuff Injuries Treated?

Rotator cuff injury treatment depends on the type and severity of the problem as well as the patient’s activity level and goals. We work with each patient to determine the right treatment plan for them.

Nonsurgical Treatments

Rest, including avoiding activities that cause pain
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to relieve swelling and pain
Physical therapy, including exercises to improve strength, flexibility, and range of motion in the shoulder
Steroid injections, such as cortisone, to reduce pain and swelling

Surgical Treatments

For rotator cuff injuries that do not improve with conservative treatment, we perform rotator cuff surgery to repair the torn tendon and reattach it to the arm bone.

Our surgical options include:

Arthroscopic surgery: In this minimally invasive procedure, our orthopedic surgeons make a few small incisions in the shoulder joint. We insert a miniature camera and instruments through the incisions to repair the torn tendon. This approach helps many patients find relief and usually results in a faster recovery.
Open surgery: In some cases, such as a large tear, our surgeons perform open surgery with one long incision to access the shoulder joint for repair.
Tendon transfer: We can replace heavily damaged tendons with another tendon taken from a nearby area.
Shoulder replacement: For severe rotator cuff injuries, our orthopedic surgeons are experts in shoulder replacement surgery. We offer reconstructive surgery, total shoulder replacement, and reverse shoulder replacement.

After rotator cuff surgery, we recommend that our patients go to rehabilitation to improve their strength and function. Learn more about our physical medicine and rehabilitation programs.

Most patients can return to their favorite activities after treatment, especially those whose injuries respond to conservative care and those who receive minimally invasive arthroscopic surgery.

Rotator Cuff Revisions

Patients with medium to large tears may need revision surgery at some point if they retear the tendon. To help prevent further tears, we often recommend biologic injections, such as platelet-rich plasma (PRP) or stem cells, after surgery to increase tendon thickness and speed recovery.

We offer the injection before, during, or after the surgery. We also specialize in the biologic augmentation of rotator cuff repairs with biologic patches, which have been shown to decrease retears.

What Support Services for Rotator Cuff Injuries Does UT Southwestern Offer?

Man doing shoulder rehab with help from physical therapist

Patients have access to a wide range of support services, including:

Physical therapy and rehabilitation programs
Pain management services
Education to support recovery and long-term joint health

What Clinical Trials Are Available for Rotator Cuff Injuries?

As an academic medical center, UT Southwestern is active in research to improve understanding and treatment of rotator cuff injuries. Some patients may be eligible to take part in clinical trials that explore new treatments or approaches.

Ask our doctors about current studies or search for clinical trials.

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