What Happens If a Rotator Cuff Tear Is Not Treated?

The rotator cuff helps centre the upper arm bone and lift or rotate the shoulder. A tear can leave the tendon unable to share load normally, so other muscles work harder. Continued use may worsen shoulder weakness, pain when lifting the arm and pain that wakes you at night. Guarding the shoulder can lead to shoulder stiffness and loss of reach. Larger or longstanding tears may be harder to repair because the tendon and muscle can become less flexible or weaker. The course varies with the tear's size, cause, age, activity and overall shoulder health.

Arrange an examination when shoulder pain, weakness or loss of lifting ability continues after an injury or does not settle with activity changes. Assessment may include movement and strength checks and, when useful, imaging. Management can involve load modification, targeted rehabilitation and pain relief; a specialist may discuss repair or another option when function is substantially affected. Follow exercises that match the diagnosis rather than repeatedly testing the painful movement.

Seek prompt assessment after a fall or sudden force that causes immediate weakness, inability to raise the arm or a marked change in shoulder shape. Arrange review for persistent night pain, increasing weakness, numbness or shoulder stiffness. Urgent help is appropriate for severe injury with loss of circulation, chest symptoms or an arm that becomes cold or discoloured.

What type and size of tear do you suspect? Is the tendon repairable? Which movements should I limit, and which exercises are safe? How will we track strength and range of motion? Could shoulder arthritis or another problem be contributing?