Rotator cuff rupture: Everything you need to know - An interview with Dr Philemon Grimm from the Department of Surgery at Zollikerberg Hospital
Dr. med. Philemon Grimm
May 13, 2026
5 min
A rotator cuff tear is one of the most common causes of shoulder pain and restricted movement. But how does a rotator cuff tear develop, what symptoms occur and when is treatment necessary? In this interview, Dr Philemon Grimm talks about modern diagnosis and treatment options. He explains what those affected should look out for, which conservative and surgical therapies are used today and how shoulder function can be restored in the best possible way.
What is the rotator cuff and what is its function in the shoulder?
The rotator cuff consists of four tendons that surround the humeral head. They transmit the force of the associated muscles that pull from the shoulder blade to the humeral head. This enables movements such as lifting, rotating and spreading the arm. At the same time, it ensures that the humeral head remains centred in the joint socket during movements.
What is the rotator cuff and what is its function in the shoulder?
The rotator cuff consists of four tendons that surround the humeral head. They transmit the force of the associated muscles that pull from the shoulder blade to the humeral head. This enables movements such as lifting, rotating and spreading the arm. At the same time, it ensures that the humeral head is centred in the joint socket during movements.
How does a rotator cuff tear occur - is it caused by wear and tear or by an accident?
A tear in the rotator cuff is often caused by age-related wear and tear, which is then referred to as a degenerative rupture. This gradual wear and tear is favoured by constant pinching of the tendon under the acromion or reduced blood flow to the tendon. With increasing age, the tendons become more susceptible to such damage, which can then enlarge over time. The symptoms typically develop gradually over a longer period of time.
Less frequently, a rotator cuff rupture can also occur suddenly as a result of an accident, for example by forcibly twisting the shoulder after a fall on the outstretched arm. Traumatic ruptures can also be caused by previous damage to the tendon, particularly in older people.
What symptoms are typical and how do those affected recognise that there could be more to it than a simple shoulder irritation?
Pain in the shoulder is typical, especially when lifting the arm or making overhead movements. Pain also frequently occurs at night, especially when lying on the affected side. Some sufferers also report a loss of strength, limited mobility or difficulties with everyday activities such as getting dressed or combing their hair.
When should you seek medical help for shoulder pain?
If symptoms persist over a longer period of time or there is a restriction in shoulder function - such as loss of strength or restricted movement - a more detailed examination is recommended. The shoulder should also be examined by a doctor after an accident, especially if the arm suddenly can no longer be lifted properly. An early diagnosis helps to avoid consequential damage and to initiate the appropriate treatment in good time.
How is a rotator cuff tear diagnosed?
A detailed specialist examination of the shoulder is crucial. This involves testing mobility and strength and localising the focus of the pain. Together with the medical history, the suspected diagnosis can already be narrowed down.
Ideally, magnetic resonance imaging (MRI / MRT) or other imaging procedures such as ultrasound or CT arthrography are also used. These examinations show the extent of the rupture, which is crucial for further treatment.
What treatment options are there - when can conservative treatment be used and when is surgery advisable?
Treatment depends on the extent of the rupture, the symptoms and the individual requirements of the person affected. Smaller or wear-related tears can often be successfully treated conservatively, for example with physiotherapy, exercises, anti-inflammatory medication or targeted infiltration. The aim is to reduce pain and improve shoulder function.
Surgery is recommended if there is a major tear, a significant loss of strength or if the symptoms persist over a longer period of time despite conservative treatment. Surgical treatment may also be advisable for fresh injuries following an accident.
How is such an operation performed and how is further treatment organised?
The procedure is usually minimally invasive using the keyhole technique, i.e. arthroscopically. A video camera and working instruments are inserted into the joint through several small incisions, allowing the damage to the tendon to be assessed in detail. Special suture anchor systems are used to reattach the tendon to the bony attachment point on the humeral head.
Immobilisation is necessary after this operation so that the tendon can heal on the bone. Immobilisation usually lasts six weeks, with different splints being used depending on the reconstructed tendon. Nevertheless, in most cases physiotherapy can be started after just a few days.
What can those affected do themselves to support healing and improve shoulder function?
It is important not to rest the shoulder permanently, but to move it in a controlled and targeted manner. Physiotherapy exercises help to rebuild mobility, strength and stability. In addition, stresses that cause pain should be temporarily reduced.
Patience and regular training play a decisive role, as the healing of the tendons takes time. Patients who smoke are also advised to stop smoking, as nicotine consumption has a negative impact on tendon healing due to its vasoconstrictive effect.
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