Rotator cuff tears (RTC) can be painful, but sometimes not. If you’ve decided that you’d rather not have surgery and are wondering whether you can live with a fully torn rotator cuff then you’re in the right place. 

You can live with a fully torn rotator cuff and have full function of your arm with no pain. 

This has been shown to be true in several published studies, such as this one titled Asymptomatic Rotator Cuff Tears, published in 2019.

In the rest of this article, I will discuss how it’s possible to live with a full-thickness RTC tear.

How to Live With a Full Thickness RTC Tear

First of all, some people will need surgery for a full-thickness rotator cuff tear. It’s not possible at this time to predict who those people will be, however, surgery is an option for some folks. 

My recommendation is to undergo 3-6 months of intensive exercise-based physical therapy to improve overall strength and range of motion and to see how you do. 

If pain levels and function go back to normal or better than normal after that period of time there is no reason you would need surgery. This means you get to live life fully without restrictions!

I would modify activities that cause significant amounts of pain with the goal of trying to get back to those activities with a progressive plan if they are required for your day-to-day functioning or enjoyment. 

In addition to exercise, you can use ice, heat,  massage, medication, and other modalities to help reduce symptoms while your body heals naturally. 

I’ll be writing another article at some point about how to heal the rotator cuff naturally that I’ll link to when I’m done. 

Damage Does Not Mean Disability

As I described in an article about rotator cuff and surgery, just because there is tissue damage as observed on an MRI does not mean that you will require a surgery. It also does not mean that you will have current disability (reduced function), or future reduced function. 

I wrote an article a while back about how our MRI shows us meniscus tears, RTC tears, and degenerative changes, in our spines, but how it doesn’t predict pain. 

MRIs show us tissue changes, not pain. 

This is why it is so important to have a solid physical examination and history done to prevent you from getting overdiagnosed. 

Overdiagnosis is a huge problem and leads to many unnecessary surgeries as well as chronic disabilities. 

Will It Heal Or Does The Body Adapt?

The tissue does not need to heal. Our body can adapt to many different types of tissue changes including tears in tendons, cartilage, etc. 

Now, if you have a patellar tendon full-thickness rupture, this is a little different as it does the lion’s share of work in relation to force transduction of the knee. 

The rotator cuff on the other hand, while important for the stability of the shoulder, is comprised of four different muscles. It is rare for all four of the RTC tendons to be completely torn. 

Long story short; our body adapts in many circumstances, and yours might too. 

Key Takeaways

• It’s perfectly reasonable to be able to live with a fully torn rotator cuff without decreased function or increased pain
• Damage does not always equal decreased function or pain
• Our body is amazing at adapting
• Some people will require surgery but this should only be done if certain signs and symptoms are present and they’ve ideally tried physical therapy for several months. 

Dr. Nate Kadlecek, PT