Rotator cuff tears and tendinopathy
Most rotator cuff problems are wear-related tendon irritation or partial tears, and many improve without surgery. Some full-thickness tears, especially after an injury in a younger, active person, are better repaired before they enlarge. Sorting out which one you have is the first step.
What it often feels like
- Ache over the outside of the upper arm, often worse at night or lying on that side
- Pain reaching overhead, behind your back or into a back seat
- Weakness lifting the arm, or a sudden loss of strength after a fall or lift
Where care usually starts
- Exam and strength testing, with X-ray and ultrasound or MRI when they would change the plan
- Activity changes and a structured strengthening program for the cuff and shoulder blade
- Short-term pain control and sleep positioning
Orthobiologics: when they fit
For tendinopathy or partial tears that haven’t improved with a good rehab effort, PRP or other treatments using your own cells may be discussed as a next step — not as a first step, and not as a replacement for repairing a tear that needs it.
When surgery is considered
Arthroscopic repair is considered for tears that are new and traumatic, enlarging, or still limiting you after conservative care. An injury does not automatically mean surgery.
How I weigh your treatment options →Get seen promptly if you notice
- Sudden inability to lift the arm after an injury
- Weakness that is getting worse
- Fever, redness or a hot, swollen shoulder
For a medical emergency, call 911.
Other shoulder conditions
General education only — not medical advice or a diagnosis. Treatment decisions are made together after an examination.