Some minor rotator cuff tears may heal on their own with treatments like rest, ice, and over-the-counter medicines. However, connective tissue (like tendons) heals slowly.
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Rotator cuff injury diagnosis and testing
If you have symptoms of a possible rotator cuff injury, schedule an appointment with one of our qualified shoulder specialists as soon as possible. Our orthopedic clinicians can perform rotator cuff injury tests that will help them understand the nature of your injury and provide an accurate diagnosis.
When you make your appointment, you’ll describe the injury and symptoms you are experiencing to the clinical team. They'll likely recommend you come in for imaging and a physical exam. The doctor will assess your shoulder pain by pressing specific points on your shoulder and moving your arm to assess your range of motion. They may also ask you to perform tasks to evaluate your shoulder strength.
Along with the physical exam, your clinician may order rotator cuff imaging, such as an ultrasound or MRI. Ultrasounds don't have the best image resolution, but they allow doctors to look quickly and easily for differences between your shoulders. Ultrasound images also enable the doctor to watch your rotator cuff in motion.
MRIs take longer and require you to be still, but they provide high-resolution images that show your shoulder in great detail.
The doctor might also order a shoulder X-ray, which can't show the tissues of the rotator cuff itself but may identify issues like bone spurs that contribute to the problem.
What type of doctor should I see for a rotator cuff injury?
An orthopedic sports medicine surgeon is the best choice for treating a rotator cuff injury. Orthopedic clinicians have specialized knowledge of the rotator cuff and shoulder, and can determine when rotator cuff surgery is necessary. If you have a rotator cuff injury, request an appointment with a shoulder specialist in our Sports Medicine service today. The sooner you see a doctor, the sooner you can resolve the problem and return to the activities you enjoy.
Treatment for rotator cuff injuries
Some rotator cuff injuries respond to conservative treatments, especially if the problem is minor. For more severe cases, the best treatment for rotator cuff injuries is often surgery.
Nonsurgical treatment for rotator cuff injuries
Minor rotator cuff injuries can be treated with nonsurgical solutions, including:
- Rest: Cease all activities that cause pain, especially if your pain worsens after the activity. Avoid repeated motions that bring your arm out to the side of the body. Your doctor may also have you wear an arm sling until your rotator cuff injury heals.
- Ice: Apply an ice bag (over a towel) to your shoulder at least twice a day for 20 minutes. Additionally, apply ice after any activity that aggravates your shoulder pain.
- Medication: Anti-inflammatory pain medications (such as Advil, Aleve, or aspirin) are an effective shoulder pain treatment and can relieve inflammation. Steroid injections are an excellent non-surgical option to reduce rotator cuff swelling and pain, though they can reduce the effectiveness of surgery.
- Physical therapy: Your doctor or nurse may refer you to a physical therapist for rotator cuff injury exercises that help prevent future problems.
Surgical treatment for rotator cuff tears
Rotator cuff surgery is often necessary for more severe injuries. It's a routine procedure, but recovery can take a long time.
The surgery involves separating the deltoid muscle and making tiny holes in the upper arm bone. Then, your surgeon will sew the tendon into the correct place by looping the suture through the holes. The tendons gradually reattach to the bone, which takes several months. You should avoid forceful use of the shoulder until your rotator cuff is completely healed. For the first six weeks, you'll also use a sling (and, in some cases, a pillow) to hold the arm still most of the time. You'll be able to take them off to perform physical therapy for your rotator cuff tear.
Learn more about how Mass General Brigham specialists diagnose and treat the full spectrum of shoulder injuries.
Rotator cuff surgery recovery timeline
Usually, rotator cuff surgery is performed using minimally invasive, arthroscopic techniques. This reduces the recovery timeline, but rotator cuff injuries can still take a long time to fully heal. Depending on the severity of the tear, it may be up to a year or more before you're completely healed.
Expect to wear a sling for six weeks after your rotator cuff surgery. Don't sleep on the injured side during this time. You may start assisted physical therapy exercises while you’re still wearing the sling.
When you stop using the sling, you'll begin active physical therapy exercises to rebuild strength and range of motion. Recovery time depends on the extent of the damage and the activity you want to pursue. Some tears will heal in four to six months, while others will take 12-14 months to return to pre-injury levels. Sufficient healing for contact sports generally takes longer than for non-contact sports.
FAQs about treating rotator cuff injuries
Rotator cuff injuries are often disruptive and make daily activities difficult, but surgery can be intimidating for many. Learning about the condition and the appropriate treatments can help you feel confident about getting the care you need.
With proper care, it may take several weeks or months to recover. If you continue overusing your shoulder, it could take longer or get worse.
It depends on factors like the severity of the tear and your pain threshold. Some studies show that some patients are fine with nonoperative treatment, even for more severe tears. In other cases, you may experience chronic discomfort and still end up getting shoulder surgery later.
Your shoulder specialist can help you weigh the risks and benefits of rotator cuff surgery based on your situation.
Rotator cuff tears cause pain in the shoulder, especially the front of the shoulder. The pain may also travel down the arm from the injured area in the shoulder.
It may or may not. For many people, a torn rotator cuff hurts intermittently. For others, there may be little to no pain. It's common for rotator cuff pain to worsen at night, especially for side sleepers who sleep on the shoulder with the tear.
Medications that relieve pain and inflammation, like NSAIDs or cortisone injections, can help. You may also need to modify your sleeping position, especially if you're a side sleeper who sleeps on the injured side.
Rotator cuff surgeries generally take from 1-2 hours, though may take longer, depending on the size and extent of the tear, and whether any other problems arise during surgery that need to be corrected, for example, the presence of bone spurs. Arthroscopic surgeries generally take less time than open surgeries.
You'll experience acute pain for several days after the operation. Pain will fade over time, but you may be tender for several months after the surgery or until your shoulder heals completely.
Yes, rotator cuff surgery, especially arthroscopic rotator cuff surgery, is usually an outpatient procedure, or day surgery, meaning patients can leave the hospital the same day to recover at home. During your consultation with your surgeon, you will discuss whether outpatient surgery is an appropriate treatment option, depending on your overall health status.
