Condition · Shoulder
Rotator cuff tear
The rotator cuff is a group of tendons that stabilise the shoulder and help lift and rotate the arm. Tears may be traumatic or degenerative, and their size on MRI is not the only treatment criterion.
Clinical context
What you should know
Partial and full-thickness tears can present very differently. Some degenerative changes are asymptomatic, whereas a traumatic tear may cause immediate, substantial weakness.
Neck pain, neuropathy, frozen shoulder or osteoarthritis may mimic or accompany a rotator cuff tear and must be distinguished clinically.
First step
Consultation and assessment
The examination checks active and passive movement, the strength of each tendon, scapular function and the cervical spine. Radiographs assess bone and osteoarthritis; ultrasound or MRI characterises the tendons when the result may change treatment.
When surgery is considered, relevant factors include whether the tear was traumatic, symptom duration, tendon retraction and quality, muscle atrophy, biological age and functional goals.
Stepwise treatment
Options are chosen according to the diagnosis and treatment goal
Conservative treatment
- temporary modification of painful activities without unnecessary immobilisation
- rehabilitation for movement, scapular control and progressive strengthening
- pain relief and, in selected cases, a carefully considered injection
- clinical review if strength decreases or symptoms change
Medication, injections and devices each have their own indications and contraindications. They are not recommended automatically and do not replace a diagnosis or monitoring of the response.
When surgery is considered
Arthroscopic repair may be indicated for traumatic tears, substantial weakness or persistent symptoms when the tendon is repairable. Massive irreparable tears may require other reconstructive procedures or, when cuff tear arthropathy is present, reverse shoulder replacement.
Do not delay
Signs that require prompt assessment
- sudden inability to raise the arm after injury
- deformity or suspected dislocation
- numbness, progressive neurological weakness or a cold limb
In an emergency or if symptoms are severe, call 112 or go to the nearest emergency department.
Frequently asked questions
Concise answers, without blanket promises
Can exercise heal a rotator cuff tear?
Exercise may improve pain and function but cannot reattach a full-thickness tear. For many patients, however, the functional improvement may be sufficient.
How long does rehabilitation take after repair?
The tendon must be protected before progressive strengthening begins. Recovery is measured in months and depends on tear size, tissue quality and any associated procedures.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
Medical reference sources
First step
Consultation, diagnosis and a clearly explained plan
This content is educational and does not replace medical assessment. Similar symptoms can have different causes and require different treatments.