Rotator cuff tears do not heal on their own without surgery, but many patients can improve functionally and decrease pain with nonsurgical treatment by strengthening their shoulder muscles. Just because there is a tear, does not necessarily mean a surgery is needed.
Without any treatment—either rest and rehabilitation or surgery—rotator cuff disorders may get worse. Over time, you may have more pain. You may lose range of motion and strength in your shoulder, making it harder to do your daily activities.
Usually, mild rotator cuff tears or sprains will heal within four weeks. In other severe cases, the recovery might take 4 to 6 months or even longer based on several factors such as the severity of the tear, age, and other health complications.
It is very uncommon to operate on a partial rotator cuff tear. In cases of deep partial tears — when more than 90 percent of the tendon is torn — surgery is recommended only if the symptoms can't be controlled with nonsurgical treatments. Specializing In: Sports Injuries to the Shoulder.
It takes six to eight weeks for the tendon to heal to the bone. Complete recovery time varies by size of the tear. For a small tears, full recovery time is about four months, for large tears, six months. For severe, massive tears, a complete recovery can take anywhere from 6 to 12 months.
Rotator cuff tendon tears often cause pain at night. The pain may even wake you. During the day, the pain is more tolerable, and usually only hurts with certain movements, such as overhead or reaching toward the back. Over time, the symptoms become much worse and are not relieved by medicines, rest, or exercise.
Massive rotator cuff tears are typically defined as rupture of at least two of the four rotator cuff tendons and/or retraction away from the attachment site of 5 cm or greater. Thus, these are generally accepted as more challenging repairs with a longer recovery.
Age. The risk of degenerative rotator cuff tears increases with age, becoming more common after age 35. However, people age 60 and over are more likely to develop degenerative rotator cuff injuries as the muscles succumb to repetitive use over time.
A rotator cuff tear may be partial or complete. A partial tear is when one of the tendons of the rotator cuff is frayed or damaged. A complete tear (also called a full-thickness tear) is when the tendon in is severed in half or pulled completely off of the bone.
Other signs that surgery may be a good option for you include: Your symptoms have lasted 6 to 12 months. You have a large tear (more than 3 cm) and the quality of the surrounding tendon tissue is good. You have significant weakness and loss of function in your shoulder.
However, it is important to realize that it may not make your shoulder feel 100% normal again. Research studies have shown that one year after surgery patients will have shoulder function which is about 80% of normal (see the attached graph from a publication in JBJS).
At what point does a rotator cuff tear require surgery to fix it? Surgery is recommended: If you have persistent pain or weakness in your shoulder that does not improve with nonsurgical treatment. Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching.
A torn rotator cuff can usually be repaired by suturing it to its original position. However, tears can recur even after surgery. Recurrent rotator cuff tears especially occur with large tears. Problems in the surgical technique or during the healing process may also contribute to its recurrence.
Because degeneration is the most common cause of tearing, then it naturally follows that as the degeneration progresses your rotator cuff tear may become larger over time. A recent study in one of our major journals studied this and found that rotator cuff tears will generally become larger over time.
Grade 0 represents a normal rotator cuff, grade 1 is superficial fraying less than 1 cm in size, grade 2 involves fraying 1 to 2 cm in size, grade 3 is tissue disruption in 2 to 3 cm of tendon, and grade 4 is a substantial cuff tear that involves a sizable flap and more than one tendon.
Rotator Cuff Repair surgeries are notoriously painful! Many patients say it is the worst pain they have ever experienced. To make matters worse, you are bound up in a sling after surgery and can't move the arm to try to “find a comfortable spot”.
Advanced age is associated with a higher incidence of rotator cuff tears (RCT),1–3 with rates as high as 80% in those older than 80 years of age. In addition to the increased prevalence of RCT with aging, there is a higher rate of large and massive tears,4 which are less amenable to surgical repair.
Untreated chronic inflammation due to a partially torn rotator cuff tendon could lead to a full-thickness tear and eventually progress to shoulder arthritis at which point you may not be able to raise your arm overhead due to shoulder weakness and pain.
Yes. Typically, the pain starts as a dull aching pain in your shoulder. As the injury progresses, it can cause radiating pain down the arm and into your hands. As a result, a person can lose the ability to raise their arm at all.
The symptoms are usually aggravated by raising the arms overhead or in activities that require reaching behind the body, such as retrieving an object from the back seat of a car. Furthermore, reaching behind the back to fasten underclothing or to pass a belt may aggravate the arm and shoulder pain.
The drop arm test is used to assess for full thickness rotator cuff tears, particularly of the supraspinatus. This can be useful when diagnosing sub-acromial pain syndrome (shoulder impingment) or to differentiate between shoulder and rotator cuff pathologies.
Red flags include: Trauma, pain and weakness, or sudden loss of ability to actively raise the arm (with or without trauma): suspect acute rotator cuff tear. Any shoulder mass or swelling: suspect malignancy. Red skin, painful joint, fever, or the person is systemically unwell: suspect septic arthritis.