Rotator Cuff Tears
The rotator cuff is a group of four muscles and their tendons — the supraspinatus, infraspinatus, teres minor, and subscapularis — that surround the shoulder joint and control rotation and elevation of the arm while keeping the humeral head centered in the glenoid socket. Rotator cuff tears are one of the most common shoulder injuries, affecting people of all ages and activity levels.
Types of Rotator Cuff Tears
Tears are classified by their cause, size, and depth. Acute tears result from a single traumatic event, such as a fall on an outstretched arm or sudden heavy lift. Degenerative tears develop gradually over years due to repetitive overhead activity, diminished blood supply to the tendon, and age-related tissue changes. Partial-thickness tears affect only part of the tendon's depth, while full-thickness tears represent a complete disruption of the tendon from the bone.
Symptoms
The hallmark symptom is pain in the outer shoulder and upper arm, often worst at night or when reaching overhead or behind the back. Weakness with lifting, rotating the arm outward, or reaching above shoulder height is common. Large or complete tears may cause significant difficulty performing everyday activities. Some tears — particularly chronic degenerative tears — are discovered incidentally on imaging in patients with minimal symptoms.
Diagnosis
Dr. Cooper evaluates rotator cuff tears with a detailed history, manual strength testing, and impingement provocation tests. MRI is the preferred imaging study, providing detailed information about tear size, location, tendon retraction, and muscle quality — all of which guide treatment decisions.
Treatment Options
Not all rotator cuff tears require surgery. Small partial tears and many full-thickness tears in older, less active patients respond well to physical therapy, activity modification, and anti-inflammatory treatment. Corticosteroid injections can provide meaningful pain relief and facilitate rehabilitation.
Surgical repair is recommended for acute full-thickness tears, large or massive tears causing significant weakness, tears that have failed conservative management, and active patients who require full shoulder function. Dr. Cooper performs arthroscopic rotator cuff repair — reattaching the torn tendon to the humeral head using suture anchors through small portals, minimizing damage to surrounding tissue. Massive or complex tears may require additional techniques such as superior capsule reconstruction or tendon transfers.
Recovery
Rotator cuff repair requires careful, protected healing. Patients wear a sling for four to six weeks while the repaired tendon incorporates to bone. Physical therapy begins with gentle range-of-motion exercises and progressively advances to strengthening. Most patients achieve functional use of the arm within three to four months and full return to sport or heavy labor within six to twelve months, depending on repair complexity.
