ROTATOR CUFF TEARS
Full-Thickness
Rotator Cuff Tears
A full-thickness rotator cuff tear means the tendon has torn completely through. Some patients continue to function surprisingly well, while others develop significant pain, weakness, and loss of shoulder function.
Tendon No Longer Attached
Loss Of Shoulder Strength
Often Worse At Night
Early Evaluation Matters
What Is A Full-Thickness Tear?
A full-thickness rotator cuff tear extends completely through the tendon, separating it from its attachment on the humerus. While some people remain surprisingly functional, others experience marked weakness, difficulty lifting the arm, and persistent pain.
Not every full-thickness tear requires surgery, but every full-thickness tear deserves thoughtful evaluation.
Common Symptoms
- Difficulty lifting the arm
- Night pain
- Weakness reaching overhead
- Pain with lifting
- Difficulty throwing
- Loss of endurance
Common Causes
- Traumatic injury
- Fall onto the shoulder
- Degenerative wear over time
- Heavy lifting injury
- Progression of a partial tear
Does Every Full-Thickness Tear Need Surgery?
No.
Treatment depends on your symptoms, shoulder strength, age, activity level, tendon quality, and goals. Some patients improve with physical therapy and activity modification, while others benefit from early surgical repair to preserve tendon quality and restore function.
Patients Who May Improve Without Surgery
- Minimal pain
- Good shoulder strength
- Low activity demands
- Stable tear on imaging
- Improving symptoms
Patients Who Often Benefit From Surgery
- Persistent pain despite therapy
- Significant weakness
- Traumatic tears
- Active lifestyle or overhead work
- Progressive tear enlargement
- Loss of shoulder function
Why Early Evaluation Can Be Important
Over time, some torn tendons retract away from the bone. The associated muscles can shrink and develop fatty degeneration, making repair more difficult. Evaluating a tear early allows you to understand whether the tendon remains repairable and what treatment options are available.
Repairable
Healthy tendon with good mobility and muscle quality.
Progressive
Tendon begins to retract and muscle quality declines.
Irreparable
Advanced tendon retraction and muscle degeneration may limit repair options.
Rotator Cuff Repair
When surgery is recommended, arthroscopic rotator cuff repair restores the torn tendon to bone using anchors and sutures. The tendon then undergoes a biologic healing process over the following months.
Repair
Reattach the tendon to bone.
Healing
Allow biologic tendon healing.
Rehabilitation
Protect the repair while restoring motion.
Recovery
Gradually return to strength and activity.
What This Means For Patients
A full-thickness rotator cuff tear is not an emergency in most cases, but it should not be ignored. The earlier a tear is evaluated, the more options are typically available. The best treatment balances pain relief, preservation of shoulder function, tendon quality, and your personal goals.