Rotator Cuff Tears: Treatment and Recovery

A Moment I See All the Time

A patient will walk into my office and tell me something like this: they fell with an outstretched hand during a game, or their dog suddenly yanked the leash on a walk, or they simply woke up one day unable to sleep on one shoulder because the pain kept jolting them awake. These stories are incredibly common. They are also the first sign that we might be dealing with a rotator cuff injury.

What a Rotator Cuff Tear Really Is

Your rotator cuff is not a single muscle. It is a team of four muscles that work together to give your shoulder strength and stability. When one of them is injured or torn, even simple movements can become painful.

The symptoms tend to be very recognizable.

You may notice:

• Pain when you lift your arm overhead.

• Weakness when you reach for something or put on a shirt.

• Pain that wakes you up at night, especially when you roll onto that shoulder.

That nighttime pain affects so many of my patients. It does more than interrupt sleep. It interferes with your body’s ability to heal and can take a toll on your mental health and energy levels.

The Shoulder, In Simple Terms

The shoulder is the only free hanging joint in the body. That freedom is what lets you reach, lift, throw, and move in all directions. The rotator cuff muscles anchor your upper arm bone to your shoulder blade so the joint stays stable while you move.

Those four muscles are:

• Supraspinatus, which helps you lift and internally rotate your arm.

• Infraspinatus, which helps with external rotation.

• Teres minor, a smaller muscle that assists with rotation.

• Subscapularis, which helps lift your arm out to the side.

When one of these muscles or its tendon is torn, the smooth coordination of the shoulder is disrupted. That is when pain, weakness, and stiffness begin to show up.

Why Rotator Cuff Tears Happen

Rotator cuff tears are extremely common. They can happen to anyone. The triggers I see most often include:

Sports and Repetitive Overhead Activity

Swimmers, baseball players, and quarterbacks are especially vulnerable because their sports demand repeated overhead motion. Over time, this stresses the rotator cuff.

Sudden Injury

A fall onto an outstretched hand or being suddenly pulled forward by a dog can overload the shoulder in an instant.

Wear and Tear Over Time

Aging affects all of us. The rotator cuff works hard every day. Eventually, small degenerative changes can make it more likely to tear.

The Vicious Cycle of Chronic Pain

When a rotator cuff tear goes untreated, pain can start affecting much more than your shoulder. It influences your sleep, your mood, your energy, and your outlook. People begin avoiding activities they love, which can lead to isolation and even depression. This is one reason I always encourage early evaluation.

How We Diagnose Rotator Cuff Tears

When you come in with shoulder pain, I start with a careful physical examination. We may get an X-ray to rule out other issues. If I need a detailed look at the rotator cuff, I order an MRI.

Here is something many people don’t expect: not every rotator cuff tear needs surgery. In fact, many partial tears respond beautifully to conservative treatment.

Treatment Options That Truly Help

I use a wide range of treatments, choosing what best fits your symptoms, your activity level, and your goals.

Physical Therapy

This is one of the most effective tools we have. Therapy focuses on strengthening the smaller shoulder muscles that support the injured area and restoring proper movement patterns. At-home exercises with resistance bands can be incredibly helpful when done consistently and with good form.

Anti-inflammatory Medications

These help reduce pain and swelling so you can participate more comfortably in therapy.

Cortisone Injections

A cortisone injection into the subacromial space can provide significant relief. It often makes therapy easier and more productive.

Regenerative Treatments

Platelet rich plasma, also known as PRP, and stem cell therapy use your own healing mechanisms to support tissue repair. The research is still evolving, but many patients have had excellent results.

Surgery When Needed

For full thickness tears or cases where conservative care is not enough, surgery may be the best option. Minimally invasive techniques allow for smaller incisions and a faster recovery. For the right patient, surgical repair can be life changing.

Practical Tips You Can Use Today

These are the same recommendations I give my own patients:

• Do not push through shoulder pain. Pain is your body’s warning system.

• If you sleep on the painful shoulder, use a pillow between your knees and a small pillow to support the injured arm.

• Skip overhead activities until you are properly evaluated.

• If you are an athlete or someone who uses your arms overhead regularly, make shoulder strengthening exercises part of your routine. Proper form matters.

• Pay attention to early warning signs. Addressing issues early often prevents bigger problems later.

When to See a Doctor

If shoulder pain is interfering with your daily activities, waking you up at night, or limiting your ability to lift your arm, it is time for an evaluation. A frozen shoulder is much harder to treat than a shoulder with a minor tear that still moves well. Early diagnosis almost always leads to better outcomes.

A Final Word of Encouragement

Your shoulders are involved in almost everything you do. From hugging your kids to carrying groceries to pursuing your favorite sport, they matter for your independence and your quality of life.

You do not have to live with shoulder pain. Whether your tear responds to therapy or needs surgery, there are effective treatments available. The key is getting a proper diagnosis and working with someone who will listen and guide you through your options.

If you are dealing with shoulder pain right now, get it evaluated. You deserve relief, and you deserve to return to the activities you love.