Conditions we diagnose and treat

Rotator Cuff Tear: Diagnosis and Treatment in London

Available at LSRI Harley Street (W1G 9QJ) and LSRI Northwest London, Harrow (HA2 7SJ).

The rotator cuff is a group of four muscles and their tendons that hold the shoulder joint steady and help lift and rotate the arm.

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GMC / FRCR Dr Prashant Sankaye, Consultant MSK Radiologist

A rotator cuff tear can be partial, where the tendon is frayed or damaged, or full thickness, where the tendon is torn through. Many tears develop gradually with age and wear, and are common from middle age onwards; some cause few symptoms. Others happen suddenly after a fall, a heavy lift or a shoulder dislocation. At LSRI, Dr Prashant Sankaye, Consultant MSK Radiologist, uses ultrasound and MRI to find out whether there is a tear, how large it is and which tendons are involved, so that you and your team can plan the right treatment.

Why choose LSRI

Consultant-led care from Dr Prashant Sankaye, Consultant MSK Radiologist with more than 20 years’ experience.
Diagnosis and ultrasound-guided treatment from the same specialist.
Two clinics: LSRI Harley Street (W1G 9QJ) and LSRI Northwest London in Harrow (HA2 7SJ).
No GP referral needed, and all major insurers accepted.
After Dr Sankaye has reported your scan, you can have a free 5-minute video consultation to go through the results.

Last medically reviewed by Dr Prashant Sankaye, Consultant MSK Radiologist, on 2 October 2026.

Symptoms of rotator cuff tear

Pain in the shoulder and upper arm, often worse when lifting the arm or reaching overhead.
Pain at night, especially when lying on the affected side.
Weakness when lifting or rotating the arm.
Difficulty with everyday tasks such as brushing your hair or reaching behind your back.
Clicking or catching when moving the shoulder.

If you suddenly cannot lift your arm after a fall, injury or dislocation, seek prompt assessment. A significant tear after an injury may need an early surgical opinion, as repair is often more successful when done without delay.

How we diagnose rotator cuff tear

Diagnosis starts with your history and a shoulder examination, including tests of strength and movement. Imaging is then used to confirm whether there is a tear and to describe it.

Ultrasound is an accurate way to look at the rotator cuff tendons. It can show whether a tear is partial or full thickness, measure its size, and check the bursa and biceps tendon. Because it is a moving scan, Dr Sankaye can also watch the tendons as you lift your arm. You can read more in our guide to shoulder ultrasound scans in London.

MRI gives a detailed picture of the whole shoulder. It shows how far a torn tendon has pulled back and the condition of the muscles, which can help a surgeon decide whether repair is possible. It also shows other structures such as the labrum and cartilage. See our guide to shoulder MRI scans in London.

An X-ray can show arthritis, calcium deposits and changes in the position of the bones that can go with a long-standing large tear.

What to expect at your appointment

Dr Sankaye reviews your symptoms, how the problem started and any previous scans.
He scans your shoulder with ultrasound, and arranges an X-ray or MRI if needed.
He explains the findings and discusses your options, including whether a surgical opinion makes sense.
If you decide to go ahead with an injection, it is done under ultrasound guidance.
You receive aftercare advice and a written report, which can be shared with your GP, physiotherapist or surgeon.

Treatment options

Treatment depends on the type and size of tear, how it happened, your age, activity levels and symptoms. Many gradual, age-related tears are managed well without surgery:

Physiotherapy: a structured programme to strengthen the remaining cuff and shoulder blade muscles is the mainstay for most degenerative tears.
Activity changes and pain relief: reducing overhead and heavy lifting for a while, and using simple painkillers if they suit you.

Options at LSRI include:

Ultrasound-guided steroid injection: in selected cases, an injection into the bursa above the rotator cuff can ease pain and help you get the most from physiotherapy. The relief is often short term, and repeated injections are generally avoided, particularly if surgery is being considered.
MSK specialist consultation: a detailed review of your symptoms and scans, with a clear explanation of the findings and next steps.

A surgical opinion is often worthwhile for a significant tear caused by a recent injury, particularly in active people, and for tears that remain painful and weak despite physiotherapy. Dr Sankaye can advise when a shoulder surgeon’s opinion is worthwhile, and his report can be shared with the surgeon.

Shoulder pain without a tear is often due to irritation of the tendons and bursa. You can read more on our shoulder impingement page.

Questions about rotator cuff tear

Should I have an ultrasound or an MRI?

Both are good at showing rotator cuff tears. Ultrasound is quick and allows Dr Sankaye to examine the shoulder as it moves. MRI gives a fuller picture of the whole joint and is often preferred when surgery is being planned. Dr Sankaye can advise which is best for you.

Will a rotator cuff tear heal on its own?

Torn tendon does not usually knit back together on its own, but many people with degenerative tears regain good, comfortable function with physiotherapy, as the other muscles learn to compensate.

Do all tears need surgery?

No. Many gradual tears are managed without surgery. Surgery is more often considered for significant tears after a recent injury in active people, or when pain and weakness persist despite treatment.

Can I have an injection if I have a tear?

In selected cases, yes. An injection into the bursa can ease pain to help you with physiotherapy. Dr Sankaye will discuss whether it is suitable, especially if surgery is a possibility.

Our clinics

Two clinics, one team

Dr Prashant Sankaye, Consultant MSK Radiologist, sees patients at Harley Street in central London and at our Northwest London clinic in Harrow. Call one number to book at either clinic.