To diagnose a rotator cuff disorder, your doctor will ask about your injury or shoulder pain history and will do a physical exam to see how your shoulder is working. Your exam may include tests of your shoulder movement and strength. If your shoulder is painful and you cannot move it much, your doctor may give you a shot of an anesthetic such as lidocaine to reduce your pain. After the shot, your doctor will test your shoulder movement and strength again. Or you may have a steroid shot to help your doctor find out if your shoulder pain is from your rotator cuff. If a steroid shot near the rotator cuff relieves your pain, even if the pain comes back later, it means the rotator cuff-and not some other shoulder problem-is causing the pain. Your doctor may also order an X-ray. An X-ray is a picture of the bones in your shoulder.

Your age, job, and activity level are considered when your doctor is deciding about further testing to diagnose a rotator cuff disorder. For example, if you are a competitive athlete or have a job that requires frequent overhead activity, you may need further testing earlier than a relatively inactive older adult. A more complete diagnosis is important if you are likely to continue activities that may further damage your shoulder.

Imaging tests that may help your doctor diagnose a rotator cuff disorder include magnetic resonance imaging (MRI) and ultrasound. In rare cases, you may have a type of X-ray called an arthrogram. If your symptoms, exam, and X-ray show that you may have a complete rotator cuff tear, you may have one or more of these tests to confirm the diagnosis. Otherwise, these tests are not usually done until you have first tried several weeks of rest, ice or heat, other home treatment measures, and rehabilitation exercises to restore shoulder strength and movement.