Rotator Cuff Repair

The rotator cuff is four tendons wrapping the shoulder, each joining muscle to bone, and together they hold the joint steady and turn the arm. When one tears, the arm loses both strength and range. Tears come suddenly — a fall on an outstretched arm, a jerking lift — or gradually, as tendon wears with age. A partial tear leaves the tendon still attached; a full-thickness tear leaves a hole through it.

How it is diagnosed

Pain at rest, especially lying on that shoulder, weakness lifting or rotating the arm, and a crackling sensation on movement are the usual complaints. The examination checks tenderness, range of motion and strength, and MRI shows the soft tissue — where the tear is and how big.

The three ways it is repaired

Arthroscopic repair works through a camera and miniature instruments and is the least invasive. Mini-open repair uses a cut of roughly three to five centimetres so the surgeon sees the tendon directly. Open repair uses a larger incision, detaching shoulder muscle to reach complex tears. Which one suits you depends on the size and shape of the tear, not on preference.

Recovery runs in stages

Weeks one to six are immobilisation: a sling, and the arm not used, while the tendon knits to bone. Passive exercises — someone else moving your arm — begin within those first six weeks. Active strengthening starts after week six. Full recovery takes several months, and physiotherapy is not optional here; it is what determines whether the shoulder ends up strong or stiff.

Before you agree to anything

Surgery is generally considered when pain persists despite conservative treatment, when symptoms have run six to twelve months without improving, when the tear is large — beyond about three centimetres — when weakness is disabling, after an acute injury, or in people who need the shoulder overhead. Ask how large your tear is, which repair is planned, and what the re-tear risk is at that size in this surgeon's hands.