Age plays an important role in the development of rotator cuff tears. As we age, so does the rotator cuff, and weakening of the tendons increases the chances of a tear occurring. For this reason, tears are most common in adults over the age of 40. However, repeated use of the arms in the overhead position often accelerates weakening of the cuff. Individuals who perform common overhead activities, such as painters and sheetrock workers, frequently develop tendonitis, and this tendonitis may eventually progress to a complete tear in one of the tendons.
Tears are also common in certain athletes who use repetitive overhead motions, such as baseball pitchers, swimmers, and tennis players. In some cases, a tear can be sustained from a direct blow - a fall from a bicycle, for example.
With a rotator cuff tear, you may experience pain primarily on top and in the front of your shoulder. Sometimes, pain may occur at the side of your shoulder, and it is usually worse with any activity that forces you to reach above the level of your shoulder. You may also experience weakness and stiffness, and it may be difficult to perform simple overhead activities like placing dishes in the cupboard. Some people with tears can't lift their arm to comb their hair. Stiffness may result from the inability to move your shoulder, and this stiffness may become progressive.
Often with a rotator cuff tear, bursitis (inflammation of the bursa, the small sac of fluid that surrounds the joint) will occur, which may cause a mild popping or crackling sensation in the shoulder. The tear itself may rub and cause this sensation. You may also have difficulty sleeping on the shoulder at night.
When a rotator cuff tear begins to interfere with normal activities, arthroscopic (minimally invasive) shoulder surgery may be necessary to restore your shoulder's full functional abilities. Then you can get back to the activities you love, or simply enjoy a good night's rest.