Medically reviewed by Dr James Bristol, MD, PhD · Updated 2026-11-14
Many rotator cuff tears, especially those that develop with age, are treated without surgery. A Finnish trial (Kukkonen, 2014) found physiotherapy alone worked as well as surgery for small non-traumatic tears at 1 and 2 years. Sudden, traumatic tears in younger, active people are more often repaired. After repair, a study (Hernigou, 2014) found adding bone-marrow stem cells improved healing and reduced re-tears.
Symptoms
- Pain lifting the arm sideways or overhead
- Night pain lying on that side
- Weakness
Tendon pain for more than 3 months? Get the free guide and a doctor review of your scan.
Treatment without surgery
- Physiotherapy: strengthening the remaining cuff and shoulder blade muscles
- Activity changes
- Injections for pain
- PRP or stem cells for partial tears or degenerative tendinopathy
When surgery is advised
- Acute traumatic tear with sudden weakness, especially under about 60
- Large tears in active people
- Failed non-surgical care