Rotator Cuff Tear —
Symptoms & Treatment
Understanding rotator cuff tears — grades, symptoms, and the full range of treatment from conservative care to surgery.
Types of Rotator Cuff Tears
The tendon is damaged but not completely severed. Accounts for the majority of rotator cuff tears. Many respond to non-surgical treatment.
Most CommonA complete tear through the tendon. Smaller tears (< 3cm) in active patients are typically repaired arthroscopically with excellent outcomes.
Surgical CandidateTears involving two or more tendons or greater than 5cm. More complex — may require advanced repair techniques or, in some cases, reverse shoulder replacement.
ComplexCommon Symptoms
- Deep aching pain in the shoulder, often worse at night
- Weakness with overhead lifting or reaching behind the back
- Difficulty sleeping on the affected shoulder
- Crackling or grinding sensation with shoulder movement
- Pain that radiates down the outer arm toward the elbow
- Limited range of motion, especially overhead
Non-Surgical Treatment First
Many rotator cuff tears — especially partial tears and degenerative tears in patients over 60 — respond well to non-surgical management. Dr. Vasileff always recommends a structured conservative trial before considering surgery.
Non-surgical options include physical therapy focused on rotator cuff and periscapular strengthening, cortisone injections for pain and inflammation control, and activity modification. Surgery is typically recommended when 3–6 months of conservative care fails to provide adequate relief, or for acute full-thickness tears in active patients.
Shoulder pain keeping you up at night?
Night pain is a hallmark of rotator cuff disease. Get evaluated early — smaller tears are easier to repair.