When Does a Rotator Cuff Tear Require Shoulder Surgery?

What is a rotator cuff tear?

The rotator cuff is a group of muscles and tendons that surrounds the shoulder joint. It helps stabilize your shoulder and allows you to lift and rotate your arm.

A rotator cuff tear occurs when one or more of these tendons become partially or completely torn. Some tears develop gradually from wear and tear, while others happen suddenly after an injury such as a fall or sports accident.

Common symptoms include:

• Pain when lifting or lowering your arm
• Shoulder weakness
• Pain that becomes worse at night
• Difficulty reaching overhead or behind your back
• Reduced range of motion

Persistent shoulder pain or weakness may require an orthopedic evaluation to determine the extent of the injury.

Do all rotator cuff tears require surgery?

No. Many rotator cuff injuries can initially be treated without surgery.

Depending on your symptoms and the severity of the tear, treatment may include rest and activity modification, anti-inflammatory medication, physical therapy, or injections.

Physical therapy can be particularly helpful for improving shoulder mobility and strengthening the muscles surrounding the joint.

However, if pain and weakness continue despite conservative treatment, surgery may become the better option.

When might rotator cuff surgery be recommended?

Shoulder surgery may be considered when:

• Pain continues despite nonsurgical treatment
• Shoulder weakness significantly affects daily activities
• You have a large or complete rotator cuff tear
• The tear occurred suddenly after an injury
• Your work or sport requires significant shoulder strength or overhead movement

The decision also depends on factors such as your age, activity level, overall health, and the severity of the injury.

At North Valley Orthopedic Institute in Tarzana and Mission Hills, CA, Dr. Ramin Ganjianpour evaluates each patient's shoulder injury individually to determine whether conservative treatment or surgery is the most appropriate approach.

What happens during rotator cuff surgery?

Rotator cuff repair is often performed using minimally invasive shoulder arthroscopy. A small camera and surgical instruments are inserted through small incisions, allowing the damaged tendon to be repaired without the larger incision required for traditional open surgery.

The type of surgery needed depends on the location and severity of the tear.

Recovery typically includes a period of protecting the repaired shoulder followed by physical therapy to gradually restore movement and strength.

If returning to sports is one of your goals, you can also read our Returning to Sports After Rotator Cuff Surgery article for more information about the recovery process.

When should you see an orthopedic specialist?

Consider having your shoulder evaluated if pain or weakness persists, interferes with sleep, limits your ability to raise or use your arm, or develops after a significant injury.

Determining the cause of shoulder pain early can help you understand your treatment options and whether surgery is necessary.

If shoulder pain is affecting your daily activities, call North Valley Orthopedic Institute or request an appointment online to schedule a shoulder evaluation at our Mission Hills or Tarzana, CA office.