Frozen Shoulder vs. Rotator Cuff Tear: How to Tell the Difference

Shoulder pain can make daily tasks like lifting a bag or reaching for something on a shelf challenging. For athletes and active individuals, it can put you on the sidelines and stop you from engaging in the activities you love. 

Two common causes of shoulder pain – frozen shoulder and rotator cuff tears – share some overlapping symptoms, which can cause confusion. However, these conditions are distinct.

The practice of Matthew Pifer, MD, specializes in orthopedic shoulder surgery and sports medicine surgery. We have extensive experience managing a full range of shoulder issues.

The goal for people with frozen shoulder is to reduce pain and restore shoulder mobility and function.

Why do I have frozen shoulder?

Frozen shoulder develops when the connective tissue surrounding the shoulder joint thickens and tightens, resulting in stiffness. The following are the three stages of frozen shoulder:

• Freezing: increasing pain and stiffness
• Frozen: limited mobility
• Thawing: gradual improvement 

Each stage can last for several months.

The exact cause of frozen shoulder isn’t clear, but it’s more common in individuals with diabetes, thyroid disorders, or those who have had prolonged shoulder immobility due to injury or surgery. 

What is a rotator cuff tear, and why am I in pain?

The rotator cuff consists of four muscles and tendons that stabilize your shoulder and allow for a wide range of motion. A tear can occur due to acute trauma, such as a fall, or from repetitive strain, especially in athletes or people performing overhead motions.

Unlike frozen shoulder, a rotator cuff tear causes sharp pain, arm weakness, and difficulty lifting the arm or performing overhead activities. In some cases, people may notice a “popping” sensation or hear a crack during the injury. 

Partial tears may respond to conservative treatments, but full-thickness tears often require surgical repair to restore function and prevent further damage. Dr. Pifer specializes in minimally invasive shoulder repair – an approach that minimizes damages to surrounding tissue and improves recovery times. 

Key differences between frozen shoulder and rotator cuff tear

While both conditions cause shoulder pain and limited mobility, key differences help distinguish one from the other.

Frozen shoulder typically involves progressive stiffness with dull, aching pain, particularly at night. People often struggle to move their arms in all directions, even with assistance.

In contrast, rotator cuff tears cause sharper, more localized pain, especially when lifting or rotating the arm. Weakness in the shoulder is another sign, making tasks like lifting objects or reaching overhead challenging.

If you’re unsure about your symptoms, Dr. Pifer will perform a thorough examination, along with imaging like X-rays or MRI, to make an accurate diagnosis.

Healing faster with the right treatment

The treatment approach varies significantly between these two conditions. For frozen shoulder, physical therapy is the cornerstone of care. Gentle stretching and mobility exercises reduce stiffness. Anti-inflammatory medications or corticosteroid injections may also ease pain and swelling.

Alternatively, rotator cuff tears often require a combination of rest, physical therapy, and, in some cases, surgical repair.

When to seek expert care

If shoulder pain persists for more than a few weeks or significantly limits your daily activities, it’s time to consult an orthopedic shoulder specialist. 

At the practice of Matthew Pifer, MD, people receive exceptional care from diagnosis to recovery. 

Don’t let shoulder pain hold you back. Schedule a consultation today.