• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
Howard J. Luks, MD, Orthopedic Surgeon

Howard J. Luks, MD

Orthopedic Surgeon Sports Medicine Specialist

  • Articles
  • Notes
  • Podcast
  • Book
  • Education
    • Shoulder Injuries
    • Knee Injuries
    • Elbow Injuries
  • About
Blog / Articles / Shoulder / Rotator Cuff

Can tendinosis or partial tears progress to full tears of the rotator cuff?

Howard J. Luks, MD Updated October 11, 2021

Featured image placeholder

Does rotator cuff tendinosis progress?

Since rotator cuff tendinosis represents a(n) (age related, genetic or post-traumatic) degenerative condition, and degenerative conditions by definition usually progress, the unfortunate answer is yes.  However, that does not always correlate with worsening of your pain or symptoms.  Some people can have severe tendinosis and insignificant pain.  Also, the rate of progression is not very rapid.  When I describe rotator cuff tendinosis to people I liken it to their favorite pair of jeans — where the area around the knee is wearing away.  With time you will eventually have a hole there.  That is what we refer to as a degenerative rotator cuff tear.   Again, this is not a rapid progression.  Trauma, falls, etc can hasten the progression, but this is not typical.  Once the tendinosis progresses to the point where some of the rotator cuff has separated from the bone, you now have a partial thickness rotator cuff tear.

Do partial rotator cuff tears progress?

The arrow in figure A points to a rotator cuff tendon. Figures B and C represent partial tears in that tendon. Figures D and E represent complete Tears. Figure D & E demonstrates a complete tear

Great question —  and a controversial question too.   Some older scientific studies show that nearly 50 percent of partial thickness tears can progress to full thickness rotator cuff tears, however, more recent studies call that into question.  Given the scientific literature that exists, you should probably NOT consider surgery to prevent a partial tear from becoming a full tear.

If you suffer from rotator cuff tendinosis or a partial rotator cuff tear — you were treated and your symptoms resolved — what next?   A repeat MRI or ultrasound study in a year or so  to visually examine the rotator cuff and be sure the tear has not progressed.  Pain or lack of pain is not an indication of progression since many other structures within the shoulder can hurt — such as the biceps tendon, the bursa, the other muscles, etc.

 

Categories: Rotator Cuff Tags: rotator cuff partial tears, Rotator cuff tears

Disclaimer:  this information is for your education and should not be considered medical advice regarding diagnosis or treatment recommendations. Some links on this page may be affiliate links. Read the full disclaimer.

Related Articles

return to work rotator cuff
Rotator Cuff Injuries
calcific tendonitis and severe shoulder pain
Why Does My Shoulder Hurt So Much?
rotator cuff healing
Why didn’t my rotator cuff heal ?
subacromial decompression
Video: Why Are Partial Rotator Cuff Tears so Common
rotator cuff return to work
Returning to work after rotator cuff surgery
Pain on top of the shoulder
Shoulder Stiffness After Rotator Cuff Surgery
Howard J. Luks, MD

Howard J. Luks, MD is an orthopedic surgeon & sports medicine specialist. An expert in shoulder, knee, and other sports injuries, he is widely known as one of the country’s best orthopedic surgeons.

Book Appointment · About · Contact

Facebook Twitter LinkedIn YouTube

Like what you’re reading?

Get the latest posts in your inbox

Reader Interactions

Comments

  1. Mike says

    September 24, 2014 at 4:53 pm

    I had SAD nearly 5 weeks ago with some minor infraspinatus debridement and a fair amount of labral debridement, probably a type 1 tear from anterior/superior to about 7:00 posterior. The shoulder has gotten fairly loose in flexion and abduction. There are a few tweaks here and there but it seems to be getting better overall. I get a fair amount of pain below the deltoid insertion doing a belly press and get a sharp tweak in the same location with external rotation when abducted more than a little bit. I can’t get internally rotated enough to do the lift off test. There’s no difference from pre-op for internal and external rotation other than a bit more pain free ER with no abduction and shoulder blades pulled together.

    If I remember correctly the radiology report attributed anything around the subscapularis as iatrogenic from the contrast injection and the post op report didn’t mention the subscapularis. The biceps tendon was in the groove.

    Is it too early to think the real culprit may be a subscapularis tear of some degree? I’m hoping it is contact with a still sensitive labrum but I’d expect a bit more improvement by almost 5 weeks. As of now, I plan to continue with PT, although I’ll mention the possibility, and see the surgeon at about 8 weeks post op.
    Thanks,
    Mike

    • Howard J. Luks, MD says

      September 28, 2014 at 7:44 am

      Good luck with your continued progress Mike. Sometimes the recovery from surgery is a lot longer than any of us want it to be.

  2. Doris says

    January 27, 2015 at 6:03 pm

    I am 68 and fell in December 2014 and have been experiencing shoulder pain since. I saw a shoulder orthopedic specialist and after MRI he advised I have a partial rotator cuff tear. He said PT will not help and recommends surgery. He is so busy that I have been unable to get scheduled for surgery yet. I asked for PT which he prescribed for 6 visits. I would like to know, I get popping with pain when I do some of the exercises. Could this increase the tear? Thanks

    • Howard J. Luks, MD says

      January 28, 2015 at 8:26 am

      Hi Doris…
      Please read our “Expert Series” on the rotator cuff in the blog section of my site. The initial treatment for partial tears is therapy. It is almost never surgical. PT is successful at alleviating the pain for many. Surgery is considered only after the failure of a non-surgical regimen. Some partial tears do progress… but as you will see in the blog, even small degenerative full tears are treated with PT as well.

      Good Luck to you.

      Howard Luks

  3. Fran says

    January 28, 2015 at 4:56 pm

    Good evening.
    I am after some advice, if that is okay. I train for triathlon, mainly long distance. I have a coach and training is usually very structured with large gains in intensity/load avoided.
    I was swimming last night, front crawl and I went to accelerate past someone and I felt a small ‘pop’ with immediate pain in the front of my shoulder. I tried to swim it off, but no such luck, so I got out the pool. I iced my shoulder and took some pain killers. The next day, I seem to get most of my pain in the armpit region with a little referral down the arm, but only in aggravating movements. Int shoulder and add I am not keen on and gurbers test provokes my pain. No bruising or sig swelling but can feel a little stiff.
    I am wondering if I have partially torn subscap? If so, what would you recommend with regards to management and length of time away from swimming?
    Thank you for your time
    Fran

    • Howard J. Luks, MD says

      January 28, 2015 at 6:57 pm

      Hi Fran ..
      Given that you are a high level athlete I would seek out a good Shoulder doc for a thorough exam and if needed either an ultrasound or MRI. No need to rest and decondition if you don’t have to.

  4. Doris says

    January 28, 2015 at 10:10 pm

    Thanks for your prompt reply Dr. Luks. Approx how many weeks or sessions of PT before concluding that PT is not working? Also, what should I expect the PT sessions to include? Thanks!

  5. Cameron says

    January 8, 2016 at 1:03 am

    Hi there i had a latarjet procedure on my right shoulder 5 months ago and i noticed some popping in my subscapularis when i do certain exercises. It doesn’t hurt at all and i am in no pain with almost full range of motion. I was just wondering that if i have a tear in my subscapularis would i be in pain or without range of motion? If you could give me some advice that would be great thanks?

« Older Comments
Newer Comments »

Primary Sidebar

Howard J. Luks, MD is an orthopedic surgeon & sports medicine specialist. An expert in shoulder, knee, and other sports injuries, he is widely known as one of the country’s best orthopedic surgeons.

Book Appointment · About · Contact

Facebook Twitter LinkedIn YouTube

Like what you’re reading?

Get the latest posts in your inbox

Longevity... Simplified: Living A Longer, Healthier Life Shouldn’t Be Complicated

My new book is available now.

Learn More
Read Reviews

Reader Favorites

  • Batters shoulder posterior labral tear
    Batter’s Shoulder : Posterior Labral Tears
  • calcific tendonitis and severe shoulder pain
    Why Does My Shoulder Hurt So Much?
  • lactate polarized training
    Lactate, the lactate shuttle, and lactate threshold workouts in polarized training
  • knee swelling
    Pain In The Front Of The Knee: 6 Common Causes
  • Zone 2 heart rate training
    Zone 2 Heart Rate Training For Longevity and Performance
  • LEg exercises improve longevity
    Runners require strength too: What to do and when to do it
  • should I have surgery
    Sometimes our joints just hurt, and it’s ok not to know why
  • Polarized training for runners
    Polarized training for everyday runners: Part 1

Howard J Luks, MD

Orthopedic Surgery & Sports Medicine
128 Ashford Avenue
Dobbs Ferry, NY 10522

Phone: (914)-559-1900
Book Appointment

Pages

  • About
  • Upcoming Books
  • Testimonials
  • In The News
  • Media Photos
  • Contact

Topics

  • Shoulder
  • Knee
  • Elbow
  • Metabolic Health
  • Osteoarthritis
  • Training

More

  • COVID
  • Ankle
  • Hip
  • PRP
  • Running
  • Sports Medicine
  • Articles
  • Notes
  • Podcast
  • Book
  • Education
  • About

© 2022 · Howard J Luks, MD · Disclaimer & Terms · Privacy Policy
The information on this site is not intended or implied to be medical advice, diagnosis, or treatment.
This site should be used for informational purposes only.