The rotator cuff is a group of 4 muscles that support your shoulder joint. This muscle group helps to raise and rotate your arm.

The rotator cuff might have a partial or full thickness tear. “Partial” or “full” thickness tears describes the extent in which the tendon is damaged.

Other ways to describe rotator cuff tears is through labelling it as acute or degenerative tears.

• Acute tears generally occur with associated trauma, such as falling down on an outstretched arm.

• Degenerative tears occur over time and naturally takes place as we age. Degenerative tears are kind of like wrinkles that form on our face as we age. People over the age of 50 would more likely have degenerative tears.  

How common is a rotator cuff tear?

Rotator cuff tears are quite common with 22% of the general population having one. The prevalence of rotator cuff tears is higher with greater age. It is actually more common to have a rotator cuff tear without symptoms compared with a rotator cuff tear that is associated with pain. This means that it is quite normal to have a tear in your rotator cuff and have no shoulder pain.

The graph below outlines the trend of greater rotator cuff pathology that is associated with age.

Prevalence of rotator cuff tear in each decade. The prevalence of full-thickness rotator cuff tear in each decade was 0% in the 20s to 40s, 10.7% in the 50s, 15.2% in the 60s, 26.5% in the 70s, and 36.6% in the 80s.

The below graph also outlines the prevalence of rotator cuff tears between male and females.

The prevalence of rotator cuff tears between males and females was quite similar in the age group 70s and 80s.

What would happen if I train with a rotator cuff tear?

Well, the short answer is you will simply develop better shoulder strength and capacity over time. Are there some things to consider however? Probably. Each person will have varying tolerance to certain shoulder positions. However, it is important to note that it is safe to train with a rotator cuff tear.

The other option is to not engage in training or movement, and that has its own inherent risks, such as reducing muscle mass, strength and function of the shoulder joint. The shoulder really enjoys movement, and its about working with a professional to find out what suits you best.

Exercise management has also shown to have a great psychological affect through increasing movement confidence, improving mood and enhancing social connection (gives people a chance to exercise with loved ones). There is nothing better than being able to enjoy an upper body training session with some friends in the gym.

What are some movements to do if I have a rotator cuff tear?

Shoulder movements can involve body weight exercises, the use of TheraBand’s, and using dumbbells and barbells. All these movements will play a role in strengthening the muscles around the shoulder, as well as other important areas like the upper back, mid-back and the chest muscles.

To kickstart your rehab, a better question to reflect on is, what shoulder position is difficult to handle at the moment, and how can I improve my ability to do it over time?

An example is someone who cannot handle overhead lifting due to significant amounts of pain or lack of confidence, might find it useful to work on other pushing variations that are below the shoulder, like the Dumbbell chest press. See example video below:

Rotator Cuff Injury: safe exercises with rotator cuff injury

What level of pain is okay to work with when doing my shoulder movements?

This is a common question that we get asked in the clinic, as sometimes it might be concerning for people to engage in movement while experiencing some pain. The flexible rule is that it is okay to work with tolerable levels of pain if it is moving you towards your meaningful goals and activities. If it is a pain experience that you find difficult to handle, you can always scale down the movement to something that is more aligned to suit you. Different ways to change a movement is to:

• Modify load
• Reduce range of motion
• Change shoulder exercise
• Change speed of movement
• Change the position of the body (i.e. laying on floor vs standing up)
• Longer rest breaks

Another thing to keep in mind is that sometimes you might have pain with the initial repetitions/sets, and it can subside as you do more. Every person’s pain experience would be different, and if you are still confused on how to approach this situation, feel free to book in a consultation with our physiotherapists or exercise physiologists to find out more.