Shoulder pain is a common complaint, especially among adults over 40, athletes, and individuals with diabetes or repetitive strain. Two of the most misunderstood shoulder conditions are Frozen Shoulder (Adhesive Capsulitis) and Rotator Cuff Tear. Though the pain may feel similar, these two conditions differ significantly in their causes, symptoms, treatments, and long-term outcomes.
As a leading shoulder specialist in Nagpur, Dr. Vishal Sahni regularly treats patients suffering from both these conditions. In this blog, we will explain the key differences between frozen shoulder and rotator cuff tear — to help you identify your symptoms and seek timely, accurate treatment.
What is Frozen Shoulder?
Frozen shoulder, medically called adhesive capsulitis, is a condition where the shoulder capsule becomes thick, tight, and inflamed, leading to progressive stiffness and pain. Over time, the range of motion becomes severely limited, making everyday tasks like combing your hair or reaching behind your back extremely difficult.
Causes of Frozen Shoulder:
Common in people aged 40–60 years
More frequent in women
Associated with diabetes, thyroid issues, or prolonged immobility
Can develop after an injury, fracture, or surgery
Sometimes appears without any clear cause
How it Progresses:
Frozen shoulder typically passes through three stages:
Freezing Stage – Pain starts gradually and worsens over weeks or months.
Frozen Stage – Pain may reduce, but stiffness increases severely.
Thawing Stage – Gradual improvement in range of motion over time.
This process can take months to even 2–3 years without proper treatment.
What is a Rotator Cuff Tear?
The rotator cuff is a group of four muscles and tendons that surround the shoulder joint, allowing smooth and controlled arm movements. A rotator cuff tear happens when one or more of these tendons are partially or completely torn.
Causes of Rotator Cuff Tear:
Sudden trauma or injury (like lifting something heavy or falling)
Repetitive overuse, especially in athletes or manual labourers
Age-related degeneration, usually after 40–50 years
Bone spurs or shoulder impingement
Types of Tears:
Partial Tear – The tendon is damaged but not completely torn.
Full Thickness Tear – The tendon is completely detached from the bone.
Unlike frozen shoulder, a rotator cuff tear does not recover naturally and often worsens over time if left untreated.
Frozen Shoulder vs Rotator Cuff Tear: Understanding the Key Differences
Let’s now dive into the distinct differences between frozen shoulder and rotator cuff tear, based on clinical experience and patient feedback at the London Orthopedic Clinic, Nagpur.
1. Onset and Cause
Frozen Shoulder
Gradual onset without injury
Often triggered by prolonged immobility or diabetes
No sudden trauma involved
Rotator Cuff Tear
Often sudden, especially after lifting, pulling, or falling
May follow repetitive overuse or wear-and-tear
Can also be age-related or post-injury
2. Pain Characteristics
Frozen Shoulder
Constant dull pain deep in the shoulder
Pain worsens at night or with movement
Can disturb sleep
Rotator Cuff Tear
Sharp pain during specific movements like lifting the arm
Pain when reaching overhead or behind
May have weakness or clicking
3. Range of Motion
Frozen Shoulder
Active and passive movement both restricted
You can’t move your arm even if someone else tries to help
Severe stiffness in all directions
Rotator Cuff Tear
Active movement restricted, passive movement normal
You may be unable to lift your arm by yourself, but a doctor can move it for you
Weakness more prominent than stiffness
4. Muscle Strength
Frozen Shoulder
Muscle strength is generally intact (unless muscle wasting occurs later)
Pain limits movement, but strength remains unaffected
Rotator Cuff Tear
Obvious weakness, especially while lifting or rotating
Difficulty holding arm in certain positions
5. Physical Examination & Diagnosis
At London Orthopedic Clinic, Nagpur, we use a combination of clinical tests and imaging:
Frozen Shoulder
Restricted range in all directions
MRI or ultrasound may show thickened joint capsule
Diagnosis is mostly clinical
Rotator Cuff Tear
Weakness in specific motions like abduction or external rotation
MRI clearly shows tear and its size
Special tests like Drop Arm Test are positive
6. Treatment Approach
Frozen Shoulder:
Early stage: Pain control with medications, hot fomentation
Physiotherapy: Regular stretching and range-of-motion exercises
Injections: Corticosteroid injections to reduce inflammation
Advanced cases: Arthroscopic capsular release by a shoulder surgeon
Rotator Cuff Tear:
Small or partial tear: Rest, physiotherapy, anti-inflammatory drugs
Injections: If pain is severe
Complete tear: Often requires arthroscopic rotator cuff repair surgery
Post-surgery rehabilitation is crucial for full recovery
7. Recovery Time
Frozen Shoulder
Can take 6 months to 2 years to fully recover
Physiotherapy plays a major role
Rotator Cuff Tear
Minor tears may recover in 4–6 weeks with therapy
Surgical recovery may take 4–6 months depending on the tear size
8. Complications if Ignored
Frozen Shoulder
May lead to permanent stiffness
Impacts daily activities like dressing, driving, etc.
Rotator Cuff Tear
Tear may enlarge
Shoulder may become permanently weak
Muscle wasting and arthritis may follow
Voice of Experience: Dr. Vishal Sahni’s Advice
“Many patients come with shoulder pain and assume it’s a minor issue or muscle sprain. But without timely diagnosis, conditions like rotator cuff tears or frozen shoulder can worsen. As a shoulder specialist in Nagpur, I urge people to not ignore shoulder pain that persists beyond 2–3 weeks.”
“Frozen shoulder and rotator cuff tear require different treatments. What works for one may not work for the other. That’s why consulting a qualified orthopedic doctor near you, especially one specialising in the shoulder, is essential.” – Dr. Vishal Sahni
When Should You Visit a Shoulder Specialist in Nagpur?
If you’re experiencing any of the following symptoms, it’s time to book a consultation:
✅ Shoulder pain that lasts beyond 2 weeks ✅ Difficulty lifting or rotating your arm ✅ Pain at night or while sleeping on one side ✅ Weakness or dropping objects from your hand ✅ Stiffness or inability to reach overhead
Why Choose Dr. Vishal Sahni at London Orthopedic Clinic, Nagpur?
✅ 24+ years of international experience in the UK and India
✅ Fellowship trained in Shoulder Surgery (FRCS Ortho, MCh Ortho)
✅ Advanced diagnosis with MRI & ultrasound facilities
✅ Expertise in arthroscopic and minimally invasive shoulder surgeries
✅ Personalised treatment and physiotherapy planning
✅ Patient-friendly approach and detailed guidance
Conclusion: Don’t Confuse the Two — Get the Right Diagnosis
Both Frozen Shoulder and Rotator Cuff Tear can cause pain, limited movement, and daily discomfort — but they’re very different conditions requiring different management. Understanding these key differences is the first step in getting the right treatment.
At London Orthopedic Clinic in Nagpur, we combine clinical expertise, advanced imaging, and patient-centered care to ensure you receive the most accurate diagnosis and effective treatment plan.
If your shoulder is holding you back, it’s time to take a step forward. Book your consultation with Dr. Vishal Sahni — a trusted Shoulder Surgeon in Nagpur — and get expert care tailored to your needs.
FAQs “Frozen Shoulder vs Rotator Cuff Tear: Key Differences Explained”.
1. What is the main difference between frozen shoulder and rotator cuff tear?
Answer: Frozen shoulder involves stiffness and pain due to tightening of the joint capsule, while a rotator cuff tear is an injury or degeneration of the shoulder tendons. In frozen shoulder, both active and passive movements are restricted. In a rotator cuff tear, you may not move the shoulder actively, but a doctor can move it passively.
2. How do I know if I have a frozen shoulder or a rotator cuff tear?
Answer: If your shoulder is stiff and you can’t move it even with assistance, it may be frozen shoulder. If it’s painful to lift or rotate the arm, but someone else can move it for you, it could be a rotator cuff tear. A clinical examination and MRI or ultrasound at a specialist clinic like London Orthopedic Clinic in Nagpur can confirm the diagnosis.
3. Is frozen shoulder more common in women?
Answer: Yes, frozen shoulder is more commonly seen in women between the ages of 40–60. It is also more prevalent in individuals with diabetes, thyroid disorders, or post-menopausal changes.
4. Can a rotator cuff tear happen without an injury?
Answer: Yes. Many rotator cuff tears develop over time due to repetitive shoulder movements, age-related wear and tear, or degenerative changes. These are known as degenerative tears and are common in people over 50.
5. Can both conditions cause pain at night?
Answer: Yes, both frozen shoulder and rotator cuff tears can cause pain at night, making it difficult to sleep on the affected side. However, frozen shoulder pain is usually dull and constant, while rotator cuff tear pain can be sharp during movement.
6. Can shoulder pain come and go in these conditions?
Answer: In frozen shoulder, pain tends to persist and gradually increases before stiffness takes over. In rotator cuff tears, pain may come and go with certain activities but can worsen if the tear enlarges.
7. Is physiotherapy effective for both frozen shoulder and rotator cuff tear?
Answer: Yes, but the goals differ. In frozen shoulder, physiotherapy aims to restore mobility and reduce stiffness. For minor rotator cuff tears, therapy helps strengthen surrounding muscles and improve function. However, large tears may require surgery.
8. How long does it take to recover from frozen shoulder?
Answer: Frozen shoulder may take 6 months to 2 years to fully resolve, depending on severity and treatment. Early diagnosis and consistent physiotherapy can speed up recovery.
9. Will a rotator cuff tear heal on its own?
Answer: Small partial tears may heal with rest, physiotherapy, and medical treatment. However, complete tears do not heal naturally and may worsen if left untreated. Surgical repair is often recommended in such cases.
10. Can diabetes cause frozen shoulder?
Answer: Yes. Diabetics are at a higher risk of developing frozen shoulder due to changes in collagen and joint capsule thickening. Up to 20% of diabetic patients may experience this condition at some point.
11. How is a rotator cuff tear diagnosed?
Answer: Diagnosis is done through clinical tests like the drop arm test, resisted movements, and imaging such as MRI or musculoskeletal ultrasound, which can clearly show the size and location of the tear.
12. Is surgery always needed for rotator cuff tear?
Answer: Not always. Small or partial tears can be managed conservatively with rest, physiotherapy, and medication. However, large or complete tears, especially in active individuals, typically require arthroscopic repair for better outcomes.
13. Can frozen shoulder return after treatment?
Answer: In some cases, especially in diabetics or those who do not follow physiotherapy properly, frozen shoulder may return. But with complete rehabilitation and control of underlying health issues, recurrence can be minimized.
14. What are the stages of frozen shoulder?
Answer: Frozen shoulder progresses through three stages:
Freezing (Painful) Stage – Gradual increase in pain and stiffness
Frozen Stage – Severe stiffness, pain may lessen
Thawing Stage – Gradual return of motion This process can span over 1–2 years if untreated.
15. Can both conditions affect my daily activities?
Answer: Yes. Both frozen shoulder and rotator cuff tear can make it difficult to do everyday tasks like lifting, dressing, reaching, or driving. Ignoring the symptoms can lead to worsening disability.
16. Which doctor should I consult for shoulder pain?
Answer: You should consult an orthopedic doctor or shoulder specialist like Dr. Vishal Sahni in Nagpur, who is trained in diagnosing and treating shoulder joint problems including rotator cuff injuries and frozen shoulder.
17. What imaging tests are done for shoulder pain?
Answer:
X-ray – To rule out bone abnormalities or arthritis
Ultrasound – Useful for assessing rotator cuff tears and inflammation
MRI – Most accurate for soft tissue injuries like tendon tears or capsule thickening At London Orthopedic Clinic, advanced imaging facilities are available under expert supervision.
18. How long does it take to recover after rotator cuff surgery?
Answer: Recovery after rotator cuff surgery can take 4 to 6 months, depending on tear size and post-operative rehabilitation. Physiotherapy is essential to regain strength and mobility.
19. Is shoulder stiffness always frozen shoulder?
Answer: No. Not all stiffness is due to frozen shoulder. Stiffness can also result from arthritis, tendonitis, or post-injury immobilization. An expert evaluation is needed for accurate diagnosis.
20. Can frozen shoulder and rotator cuff tear occur together?
Answer: Yes, in some cases, a patient may have both conditions simultaneously. For example, after a minor injury, a rotator cuff tear may lead to immobility, which then triggers frozen shoulder. A shoulder specialist can differentiate and plan a proper treatment approach.
21. Why should I choose London Orthopedic Clinic in Nagpur for shoulder treatment?
Answer: London Orthopedic Clinic, led by Dr. Vishal Sahni, offers:
Expertise in shoulder, elbow, wrist, and hand conditions
24+ years of experience including international training in London and Liverpool
