One of the most common causes of shoulder pain is a rotator cuff tear, but not all tears are the same. Understanding the difference between partial and full-thickness tears can help guide treatment and recovery decisions. Here’s what you need to know to make informed decisions about your care..
When Shoulder Pain Means More Than Just Soreness
The rotator cuff is a group of four muscles and their tendons that stabilize the shoulder joint and allow smooth arm movement. These tendons can become damaged from injury, repetitive overhead motions, or age-related wear. The severity of the damage determines whether it is a partial-thickness or full-thickness tear.
Partial Tears: The “Frayed Rope” of Your Shoulder
A partial-thickness tear occurs when the tendon is damaged but not completely severed.
The tear may involve only the top or underside of the tendon and can range from mild fraying to a deeper split within the tissue.
Common symptoms include:
- Shoulder pain, especially with certain movements
- Weakness when lifting or rotating the arm
- Discomfort when sleeping on the affected shoulder
Partial tears may respond well to non-surgical treatments such as physical therapy, activity modification, and anti-inflammatory medications. In some cases, arthroscopic surgery to debride the frayed edges of the rotator cuff is recommended if symptoms persist.
Full-Thickness Tears: When the Rope Snaps
A full-thickness tear, sometimes called a complete tear, occurs when the tendon is fully detached from the bone. This can result from a sudden injury, such as a fall, or from progressive tendon degeneration over time.
Typical symptoms include:
- Significant weakness in the affected arm
- Difficulty lifting or rotating the arm
- Persistent pain that may interfere with daily activities
Full-thickness tears often require surgical repair to reattach the tendon to the bone, particularly in active individuals or those experiencing functional limitations. Arthroscopic rotator cuff repair is a common technique used.
Why the Type of Tear Matters for Recovery
The extent and pattern of the tear directly influence both treatment options and healing timelines. A partial-thickness tear may still have enough healthy tendon attached to the bone to allow the muscle to function, making non-surgical approaches more effective in many cases. In contrast, a full-thickness tear completely disrupts the tendon’s connection to the bone, which means the muscle can no longer work properly, often requiring surgical reattachment to restore strength and motion.
Tear type also impacts rehabilitation. Partial tears may heal with a shorter course of physical therapy and quicker return to activity, while full-thickness repairs typically need longer protection, gradual strengthening, and a more cautious return to sports or heavy lifting. Left untreated, some partial tears can enlarge over time, eventually becoming full-thickness tears that are more difficult to repair.
That’s why an accurate diagnosis, confirmed through a physical exam and imaging such as MRI or ultrasound, is essential. Matching the treatment plan to the severity of the tear, your age, activity level, and personal goals gives you the best chance of regaining full shoulder function and preventing future injury.
If you are experiencing persistent shoulder discomfort or weakness, contact Dr. Shah to schedule a comprehensive evaluation and discuss your treatment options.
AUTHOR: Anup Shah, MD, MBA, FAAOS is a board-certified, fellowship-trained Sports Medicine Orthopedic surgeon specializing in Knee and Shoulder Surgery in Phoenix, Arizona at Banner Health. Dr. Shah uses a patient-centric and evidence-based approach to help his patients achieve their desired goals.
