Occasionally, patients may have a traumatic rotator cuff tear, which is more common in younger patients. These patients will have an episode of trauma, like fall or sudden injury, which may cause a traumatic tear of the rotator cuff by impinging it against the acromion. These patients may have sudden onset of severe pain, which may or may not be associated with black or bluish discoloration of the skin. These patients will also have nighttime pain and discomfort along with inability to perform overhead activities as well as reaching back.