The Centers for Advanced Orthopaedics
Maryland Orthopedic Specialists
A Division of The Centers for Advanced Orthopaedics
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Shoulder

Rotator Cuff Tears

A rotator cuff tear is one of the most common sources of shoulder pain and disability in adults — and one of the most successfully treated conditions in orthopedic surgery. Whether your tear is the result of an acute injury or years of cumulative wear, our fellowship-trained shoulder specialists offer the full spectrum of care, from structured non-operative management to advanced arthroscopic repair. Most patients return to full function and the activities they love.

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What is 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, hold the humeral head centered in the glenoid socket, and power the arm through rotation and elevation.

The rotator cuff is a group of four muscles and their tendons — the supraspinatus, infraspinatus, teres minor, and subscapularis — that surround the shoulder joint, hold the humeral head centered in the glenoid socket, and power the arm through rotation and elevation. Together they are the dynamic stabilizers of the shoulder.

Tears occur when one or more of these tendons are damaged. They are classified by depth and extent:

  • Partial-thickness tears involve less than the full depth of the tendon. They may be articular-sided (facing the joint), bursal-sided (facing the subacromial space), or intratendinous. Tears involving more than 50% of tendon thickness carry a significantly higher risk of progression and symptom failure with non-operative management.
  • Full-thickness tears extend completely through the tendon, creating a communication between the joint and the subacromial bursa. These range from small (< 1 cm) to massive (> 5 cm, involving two or more tendons).
  • Massive and irreparable tears present unique reconstructive challenges and may require augmentation or alternative procedures.

The supraspinatus is the most commonly injured tendon, followed by the infraspinatus. Tears occur most often at the "critical zone" — a region of relative avascularity near the tendon insertion on the greater tuberosity.

Rotator cuff tears affect an estimated 30% of adults over 60 and up to 80% of those over 80, though many are asymptomatic. In younger patients and athletes, tears are more commonly traumatic — resulting from a fall on an outstretched arm, a forced overhead movement, or a shoulder dislocation.

Treatment options

Treatment is individualized based on tear type and size, symptom duration, your age, activity level, and functional demands. We present all options honestly and collaboratively.

Non-Operative Management

Non-operative care is the appropriate first-line treatment for most partial-thickness tears, many small-to-medium full-thickness tears in older or lower-demand patients, and for patients who are medically unsuitable for surgery. Published data demonstrate an overall success rate of approximately 75% with structured non-operative management, though tear progression occurs in a meaningful proportion of patients over 5–10 years.

Surgical Procedure

Arthroscopic Rotator Cuff Repair

Arthroscopic repair of a full or partial-thickness rotator cuff tear using suture anchors to reattach the tendon to its footprint on the greater tuberosity. Performed as an outpatient procedure at our ambulatory surgery center.

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Shoulder Arthroscopy (Diagnostic & Operative)

Minimally invasive diagnostic and operative scope of the glenohumeral joint and subacromial space, used to evaluate and treat labral tears, rotator cuff pathology, AC joint arthritis, loose bodies, and synovitis.

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Frequently Asked Questions

Do I need surgery for a rotator cuff tear?
Not necessarily — it depends on the tear type, size, your age, and your functional goals. Partial tears and degenerative full-thickness tears in older, lower-demand patients often respond well to physical therapy and injections. However, acute traumatic tears, tears in younger active patients, and tears that have failed structured non-operative treatment are generally best treated surgically. We will give you an honest recommendation based on your specific tear and your goals.
Can a rotator cuff tear heal on its own?
Partial tears have some capacity for symptom improvement with conservative treatment, though structural healing is unusual. Full-thickness tears do not heal spontaneously. Without treatment, many tears — particularly those involving more than 50% of tendon thickness — will progress in size over time, and muscle quality will deteriorate, potentially making future repair more difficult or less successful.
How long does recovery take after rotator cuff surgery?
The sling is typically worn for 4–6 weeks. Most patients recover functional use of the arm by 3–4 months and can return to light activity. Full return to overhead sport or heavy manual work takes 6–12 months depending on tear size. Overhead athletes should anticipate the longer end of this range.
What is the difference between a partial and a full-thickness tear?
A partial tear does not go all the way through the tendon — it involves only a portion of the tendon's depth. A full-thickness tear extends completely through the tendon, creating an opening between the joint and the bursa above. Full-thickness tears are generally more symptomatic and more likely to require surgical repair, particularly in active patients.
Will my rotator cuff tear get worse if I don't have surgery?
Many rotator cuff tears — especially degenerative ones — do progress in size over time, and muscle quality can deteriorate with prolonged denervation and disuse. For some patients this is clinically irrelevant; for others, particularly those with larger tears or higher functional demands, delay can make future repair more technically challenging. We will monitor your tear and advise you honestly if the window for optimal surgical outcomes is closing.
What is the success rate of rotator cuff surgery?
Arthroscopic rotator cuff repair has excellent clinical outcomes, with the large majority of patients reporting significant improvement in pain and function. Structural re-tear rates vary by tear size — smaller tears heal at rates exceeding 90%, while large and massive tears carry higher re-tear rates. Importantly, clinical outcomes (pain relief and functional improvement) remain good even in patients with structural re-tears, though strength recovery may be incomplete.

Meet the specialists

Christopher S. Raffo, MD

Christopher S. Raffo, MD

Orthopedic Surgery · Sports Medicine

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John J. Christoforetti, MD

John J. Christoforetti, MD

Orthopedic Surgery · Sports Medicine · Hip Preservation Surgery

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James S. Gardiner, MD

James S. Gardiner, MD

Orthopedic Surgery · Sports Medicine

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Related conditions

Shoulder Impingement / Rotator Cuff TendinopathySubacromial BursitisBiceps Tendinitis / Proximal Biceps Tendon RuptureSLAP TearCalcific Tendinitis of the Shoulder
Medically reviewed by Christopher S. Raffo, MD
Last reviewed June 12, 2026

References

  1. Millett PJ, Warth RJ. Posterosuperior Rotator Cuff Tears: Classification, Pattern Recognition, and Treatment. Journal of the American Academy of Orthopaedic Surgeons (JAAOS). 2014;22(8):521–534. doi:10.5435/JAAOS-22-08-521
  2. McFarland E, Łukasiewicz P, Weber S. Partial Rotator Cuff Tears: Algorithmic Approach to Treatment. Annals of Joint. 2023. doi:10.21037/aoj-22-38
  3. McNeil DS, Athwal G, Moktar J, et al. Position Statement: Management of Rotator Cuff Tears in Adults. Canadian Journal of Surgery. 2023;66(3):E290–E299. doi:10.1503/cjs.022221
  4. Aden A, Aburas L, Masood Q, Alsayeh S. Surgical Interventions for Rotator Cuff Tears: A Comprehensive Literature Review. Cureus. 2024;16(12):e75606. doi:10.7759/cureus.75606
  5. Comparative Analysis of Single-Row vs. Double-Row Technique for Rotator Cuff Repair. PMC / PubMed Central. 2025. PMID:PMC12573510
  6. Return to Sports after Rotator Cuff Repair. PMC / PubMed Central. 2024. PMC11529348. doi:10.1016/j.jisako.2023.03.411
  7. Non-Operative Management of Rotator Cuff Tears. The Open Orthopaedics Journal. 2016;10:349–357. PMC5041208
  8. Outcomes of Initial Nonoperative Treatment of Traumatic Full-Thickness Rotator Cuff Tears. PubMed. 2024. PMID:38182019
  9. Management of Rotator Cuff Injuries — Clinical Practice Guideline. American Academy of Orthopaedic Surgeons (AAOS). 2025. aaos.org/rccpg2025
  10. Bioinductive Patch as an Augmentation for Rotator Cuff Repair: A Systematic Review and Meta-analysis. Journal of Shoulder and Elbow Surgery. 2024;33(11):2515–2529. doi:10.1016/j.jse.2024.05.002
  11. Randomized Controlled Trial: REGENETEN Bioinductive Implant Reduces Full-Thickness Rotator Cuff Re-tear Rates by 68%. Smith+Nephew Clinical Data / RCT Publication. 2024. smith-nephew.com/regeneten-rct