Overview

The rotator cuff is a group of muscles and tendons that surround the shoulder joint. These muscles keep the ball of the upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder that worsens at night.

Rotator cuff injuries are common and increase with age. These injuries may occur earlier in people who have jobs that require repeatedly performing overhead motions, such as painters and carpenters.

Physical therapy exercises can improve flexibility and strength of the muscles surrounding the shoulder joint. For many people with rotator cuff problems, these exercises are all that's needed to manage their symptoms.

Sometimes, rotator cuff tears may occur from a single injury. In those circumstances, people should seek medical advice quickly because they might need surgery.

Video: Rotator cuff damage

The rotator cuff is a group of muscles and tendons that hold the shoulder joint in place and allow you to move your arm and shoulder. Problems occur when part of the rotator cuff becomes irritated or damaged. This can result in pain, weakness and reduced range of motion.

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Symptoms

The pain associated with a rotator cuff injury may:

Be described as a dull ache deep in the shoulder.
Disturb sleep.
Make it difficult to comb your hair or reach behind your back.
Be accompanied by arm weakness.

Some rotator cuff injuries don't cause pain.

When to see a doctor

Your family healthcare professional can evaluate short-term shoulder pain. See your care team right away if you have immediate weakness in your arm after an injury.

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Causes

Rotator cuff injuries are most often caused by progressive wear and tear of the tendon tissue over time. Repetitive overhead activity or prolonged bouts of heavy lifting can irritate or damage the tendon. The rotator cuff also can be injured in a single incident during falls or accidents.

Risk factors

The following factors may increase the risk of having a rotator cuff injury:

Age. The risk of a rotator cuff injury increases with age. Rotator cuff tears are most common in people older than 50.
Some occupations. Jobs that require repetitive overhead arm motions, such as carpentry or house painting, can damage the rotator cuff over time.
Certain sports. Some types of rotator cuff injuries are more common in people who participate in sports such as baseball, tennis and weightlifting.
Family history. There may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in certain families.

Complications

Without treatment, rotator cuff problems may lead to permanent loss of motion or weakness of the shoulder joint.

By Mayo Clinic Staff

Rotator cuff injury care at Mayo Clinic

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Diagnosis & treatment

May 22, 2025

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Marigi EM, et al. Improved yet varied clinical outcomes observed with comparison of arthroscopic superior capsular reconstruction versus arthroscopy-assisted lower trapezius transfer for patients with irreparable rotator cuff tears. Arthroscopy. 2023; doi:10.1016/j.arthro.2023.04.012.
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