Rotator Cuff Tear
A rotator cuff tear involves one or more tendons that help lift, rotate, and stabilize the shoulder.
What is a rotator cuff tear?
The rotator cuff is formed by four tendons that surround the humeral head and help control shoulder motion. A tear may be partial thickness, involving only part of the tendon, or full thickness, extending through the entire tendon. Tears range from small focal defects to large injuries involving multiple tendons. Acute tears often follow a fall, dislocation, sudden pull, or heavy lift. Chronic tears usually develop from age-related degeneration and repetitive load. Many patients have a combination of preexisting tendon wear and a new injury.
Symptoms and diagnosis
Common symptoms include night pain, pain with overhead use, weakness lifting or rotating the arm, difficulty reaching behind the back, and loss of endurance. Sudden weakness after trauma deserves prompt evaluation because an acute repairable tear may benefit from earlier treatment. Diagnosis begins with the history and physical examination. X-rays evaluate the bones, arthritis, and other causes of pain. MRI or ultrasound defines tear size, retraction, muscle quality, and associated biceps or labral disease when imaging will affect treatment.
Nonsurgical treatment
Many degenerative tears can initially be treated with activity modification, appropriate medication, and physical therapy focused on motion, rotator cuff strength, and shoulder-blade control. A single corticosteroid injection may provide short-term relief in selected patients, but repeated corticosteroid injections are generally avoided, especially when repair may be considered. Nonsurgical care does not make every tear disappear, but it can improve pain and function. Progress is judged by the patient's symptoms, strength, goals, and whether the tear is at risk of becoming more difficult to repair.
When surgery is considered
Surgery may be appropriate for an acute traumatic full-thickness tear, meaningful weakness, high functional demands, progression of a repairable tear, or symptoms that remain unacceptable after a well-executed nonsurgical program. Age alone does not determine candidacy. Arthroscopic repair may include release and mobilization of the tendon, preparation of the bone, fixation with anchors and sutures, and treatment of associated biceps or labral pathology. Repair configuration is chosen according to tear pattern, tissue quality, and the available tendon.
Patient Experience
“His entire practice is organized, efficient, and thorough. He explained all the options, precautions, and considerations, which gave me a clear understanding of what to expect. On the day of surgery, he documented the procedure with photos and promptly shared them with my wife to reassure her that everything had gone smoothly.”
Patient following arthroscopic rotator cuff repair | Google review
These testimonials describe individual patient experiences. Treatment recommendations, recovery, and outcomes vary by patient.
Recovery and healing
The tendon must heal back to bone, so the shoulder is protected in a sling during the early phase. Motion is restored gradually, followed by active use and strengthening. Recovery is measured in months, and strength can continue to improve for a year or longer. Healing is influenced by tear size, muscle degeneration, age, smoking, diabetes, tissue quality, and adherence to rehabilitation. Even with technically sound surgery, not every tendon heals completely. The objective is meaningful pain relief, improved function, and the best healing environment the individual patient can achieve.
This information is educational and is not a substitute for an individualized medical evaluation. Written and medically reviewed by Michael L. Knudsen, MD | Last reviewed: July 2026
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