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?
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.