What it is
The rotator cuff is made up of four muscles, the supraspinatus, infraspinatus, teres minor and subscapularis, whose tendons wrap around the head of the humerus. Together they lift and rotate the arm and keep the joint stable.
Tears may be partial (fraying of part of the tendon) or full-thickness (a hole through the tendon). Some happen suddenly, after a fall or lifting something heavy. Many develop gradually as tendons weaken with age and repetitive overhead use.
Symptoms
- Pain over the outside of the shoulder, often worse at night or when lying on that side
- Pain or weakness when lifting the arm or reaching overhead
- Difficulty reaching behind your back
- A sudden loss of strength after a fall or heavy lift
Diagnosis
Diagnosis starts with a careful history and a hands-on examination of shoulder motion and strength. X-rays evaluate the bones and look for arthritis; MRI or ultrasound shows the tendons and the size of a tear.
Treatment options
Non-surgical
- Activity modification to calm irritated tissue
- A guided physical therapy program to restore motion and strengthen the muscles around the shoulder
- Anti-inflammatory medication when appropriate
- A corticosteroid injection in selected cases
Surgical
- Arthroscopic rotator cuff repair. Through small incisions, the torn tendon is reattached to the bone with sutures and anchors.
- Surgery may be considered for acute tears from an injury, tears in younger active patients, or symptoms that persist despite a dedicated course of therapy.
- Large tears that cannot be repaired directly may be treated with other reconstructive options.
Recovery
- First weeks
The arm is usually protected in a sling while the repair begins to heal, typically for several weeks.
- Early rehab
Physical therapy restores motion step by step, starting with gentle, therapist-guided movement.
- Strengthening
Strengthening begins once the tendon has had time to heal, usually a few months after surgery.
- Full recovery
Many patients regain most daily function within several months; full strength can take up to a year.
Timelines are typical ranges, not guarantees. Recovery depends on the specific injury, the procedure, your health and your rehabilitation, and your plan is individualized.
Questions patients ask
Will a rotator cuff tear heal on its own?
Full-thickness tears generally do not heal on their own, but pain and function often improve with physical therapy. Partial tears frequently respond well to non-surgical care.
Does every tear need surgery?
No. Treatment depends on the type and size of the tear, your symptoms, your activity goals and your overall health.
How long will I wear a sling after repair?
It varies with the size of the repair, but a sling is commonly used for several weeks.
This page is general patient education and is not a substitute for an in-person evaluation.