Shoulder pain and weakness can make even simple tasks—like reaching overhead or lifting objects—feel impossible. For many patients, the root cause involves damage to the rotator cuff, a group of muscles and tendons that keep the shoulder joint stable and functional. When a rotator cuff tear occurs, it can lead to—or worsen—shoulder instability, a condition where the shoulder loses its normal strength, alignment, and range of motion.
At Steven Struhl, MD – Shoulders & Knees, with convenient locations in New York City and Westchester, Dr. Struhl provides expert diagnosis and advanced treatment for both rotator cuff injuries and shoulder instability. As a board-certified orthopedic surgeon specializing in shoulder repair and reconstruction, he helps patients restore movement, reduce pain, and regain confidence in their shoulder’s strength.
Understanding the Rotator Cuff
The rotator cuff consists of four muscles and their tendons—the supraspinatus, infraspinatus, teres minor, and subscapularis—that surround the shoulder joint. Together, they stabilize the ball of the upper arm bone (humerus) in the shoulder socket (glenoid).
When these tendons are torn or weakened, either from injury, repetitive motion, or aging, the shoulder loses much of its natural stability. This can lead to chronic pain, weakness, and a sensation of the shoulder “slipping” or “giving out.”
According to the American Academy of Orthopaedic Surgeons (AAOS), approximately two million people in the United States experience a rotator cuff tear each year, making it one of the most common causes of shoulder dysfunction.
How a Rotator Cuff Tear Leads to Shoulder Instability
A healthy rotator cuff keeps the shoulder joint centered and stable during motion. When one or more of these tendons tear, the humeral head may shift upward or out of place. This abnormal movement puts added stress on the shoulder capsule and labrum, increasing the risk of recurrent instability or dislocation.
This instability may present as:
- A loose or weak feeling in the shoulder
- Recurrent subluxations (partial dislocations)
- Difficulty lifting or rotating the arm
- Pain during overhead motion or while sleeping on the affected side
Over time, the combination of instability and poor joint mechanics can accelerate cartilage wear, leading to shoulder arthritis or, if left untreated, further soft-tissue damage.
Common Causes and Risk Factors
While a single traumatic event—such as a fall or sports injury—can cause both a rotator cuff tear and instability, these conditions often develop gradually.
Common contributing factors include:
- Repetitive overhead activities (swimming, tennis, weightlifting)
- Age-related degeneration of tendons
- Poor posture or muscle imbalance
- Previous shoulder dislocation or surgery
- Occupational strain involving lifting or reaching
Patients over 40 are particularly susceptible to degenerative rotator cuff tears, while younger athletes may experience instability from ligament stretching or labral injuries.
Diagnosis and Treatment Options
Dr. Struhl begins with a comprehensive evaluation, including a detailed physical examination, motion testing, and imaging such as MRI or ultrasound to identify the extent of damage. His goal is to create a personalized treatment plan that addresses both the torn rotator cuff and the underlying instability.
Non-Surgical Treatment
For partial tears or mild instability, Dr. Struhl may recommend:
- Physical therapy to strengthen shoulder stabilizers
- Activity modification and ergonomic adjustments
- Anti-inflammatory medication
- Ultrasound-guided injections, such as PRP or corticosteroids, for pain relief
Surgical Treatment
In cases of significant tearing or chronic instability, minimally invasive arthroscopic repair may be necessary. Dr. Struhl specializes in advanced arthroscopic rotator cuff repair and shoulder stabilization techniques, restoring the structural integrity of the joint while minimizing scarring and recovery time.
By addressing both the tendon tear and the instability, patients can expect improved shoulder function, less pain, and a reduced risk of future injury.
Expert Shoulder Care in NYC and Westchester
Whether you’re an athlete, an active professional, or someone dealing with age-related shoulder weakness, Dr. Steven Struhl provides expert care tailored to your needs. With over 25 years of specialized experience in shoulder and knee surgery, he’s known for combining precision, innovation, and compassionate care.
If you’re experiencing shoulder pain, weakness, or instability, don’t wait for symptoms to worsen. Schedule a consultation at Steven Struhl, MD – Shoulders & Knees in New York City or Westchester and get back to living—and moving—without limitations.
