A rotator cuff tear occurs when one or more of the four muscles and tendons that stabilise your shoulder become damaged. Understanding whether you have a partial or complete tear helps determine the most appropriate treatment approach for your specific situation.
What is a Rotator Cuff Tear?
The rotator cuff is a group of four muscles and their tough, cord-like tissues (called tendons) that help hold your shoulder joint in place. These tendons connect the muscles to the bones and allow you to lift, rotate, and move your arm smoothly.
A rotator cuff tear happens when one or more of these tendons become damaged, either from an injury or from wear and tear over time. This can lead to pain, weakness, and limited movement in your shoulder.
There are several types of rotator cuff tears:
Partial tear: Only part of the tendon is damaged, while the rest is still attached.
Complete tear (full-thickness): The tendon is completely torn through, leaving a gap.
Degenerative tear: Develops slowly with age or repeated shoulder use over time.
Traumatic tear: Happens suddenly due to an injury, such as a fall or heavy lifting.
Symptoms of a Rotator Cuff Tear
Both types of tears share similar symptoms, though complete tears typically cause more severe pain and functional limitations.
- Pain patterns include aching that worsens at night, particularly when lying on the affected side
- Movement difficulties such as trouble lifting your arm overhead or reaching behind your back
- Weakness when performing activities like brushing hair or lifting objects
- Clicking sensations during shoulder movement, particularly with overhead activities
Causes and Risk Factors
Both tear types develop through similar mechanisms, though complete tears often require more significant force or advanced degeneration.
- Ageing: Tendons naturally weaken over time, making tears more likely after age 40
- Repetitive use: Sports or work involving repeated overhead motion (e.g. painting, swimming) can strain the rotator cuff
- Acute injury: A sudden fall or lifting something heavy the wrong way can cause tearing
- Poor blood supply: With age, reduced blood flow to the rotator cuff can impair healing and increase the risk of damage
Key Differences Between Partial and Complete Tears
Understanding how these two tear types differ can help you and your healthcare provider choose the most effective treatment path.
Pain Intensity
- Partial tear: Pain is usually mild to moderate and occurs with movement or pressure.
- Complete tear: Pain can be severe and constant, often affecting sleep and daily activities.
Functional Ability
- Partial tear: You may still manage overhead or rotational movement with some discomfort.
- Complete tear: Shoulder strength and motion are often significantly reduced, making basic tasks difficult.
Healing Response
- Partial tear: Often responds well to rest, physiotherapy, and lifestyle changes. Remaining tendon fibres provide some structural support for healing. Often improve within 6-12 weeks with appropriate treatment and activity modification
- Complete tear: Tendon ends are separated and unlikely to heal without surgical intervention, especially in active individuals. Typically require 3-6 months for full recovery, particularly after surgical repair
Treatment Approach
- Partial tear: Typically managed with non-surgical treatments such as physiotherapy, anti-inflammatory medication, and activity modification.
- Complete tear: More likely to require surgery, particularly for younger or physically active patients, or if symptoms persist beyond 3–6 months.
Treatment Options for Rotator Cuff Tears
Treatment for rotator cuff tears is tailored to the type and severity of the tear, as well as your age, activity level, and overall shoulder function.
Non-Surgical Treatment
Many partial tears and even some complete tears in low-demand individuals can improve with conservative care. These approaches aim to relieve pain, restore shoulder function, and prevent further damage.
Physiotherapy: Targeted exercises strengthen the shoulder muscles, improve flexibility, and support the healing of the injured tendon.
Pain Management
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce pain and inflammation.
- Corticosteroid Injections: May be used for short-term relief if pain is severe and limits rehabilitation.
- Platelet-Rich Plasma (PRP) Therapy: In select cases, PRP injections can promote tissue healing, especially for smaller, partial tears.
Activity Modification: Avoiding overhead lifting and repetitive shoulder movements allows the tendons to recover.
Rest and Cold Therapy: Applying cold packs and limiting movement early on can reduce swelling and discomfort.
Supportive Devices: A sling or shoulder brace may be used temporarily to support the joint and prevent further strain.
Surgical Treatment
If non-surgical treatments do not provide sufficient relief particularly in complete tears or persistent partial tears surgery may be recommended by an orthopaedic specialist in Singapore. Surgical intervention aims to restore tendon attachment and shoulder function.
Arthroscopic Repair: A minimally invasive procedure using small incisions and a camera (arthroscope) to reattach the torn tendon to the bone. This is the most common technique for many tear types.
Mini-Open Repair: Combines arthroscopic guidance with a small open incision to access and repair the tendon.
Open Repair: A traditional approach used for large, complex, or retracted tears, involving a larger incision for better exposure.
Tendon Transfer: In cases where the rotator cuff cannot be repaired, a nearby tendon is transferred to restore shoulder movement.
Shoulder Replacement (Reverse Total Shoulder Arthroplasty): Considered in severe cases where rotator cuff damage is combined with advanced arthritis. This procedure replaces the damaged joint surfaces with artificial components.
When To See An Orthopaedic Specialist
While many rotator cuff tears can be managed without surgery, some cases require specialist care, especially if symptoms persist or significantly affect your daily life.
You should consider seeing a shoulder specialist if you experience:
- Persistent shoulder pain lasting more than 3 to 6 months, despite rest, physiotherapy, or other non-surgical treatments
- Limited shoulder function that interferes with work, sports, or everyday activities
- Larger or complex tears, especially in younger or more active individuals where full shoulder strength and mobility are important
- Acute injuries from falls, heavy lifting, or sports that result in sudden weakness or restricted movement
Conclusion
Recognising the differences between partial and complete rotator cuff tears can guide appropriate treatment and recovery. If shoulder pain or weakness persists, schedule a consultation with our orthopaedic specialist to explore the best care for your condition.
