Can a Torn Rotator Cuff Heal on Its Own?

Your rotator cuff is made up of four muscles and ligaments that help balance the shoulder and move the joint. A tear or injury can cause a dull ache in the shoulder, which frequently worsens the more you use your arm or try to lift objects.

Rotator cuff tears are common, and the risk increases with age. They are commonly seen in people whose jobs require them to perform repetitive overhead movements, such as painting or construction work.

Rotator cuff injuries range from mild to severe, and can be separated into three categories:  

1. Tendinitis: Caused by overuse of the rotator cuff, leading to inflammation.
2. Bursitis: Caused by irritated bursa, which are liquid-filled sacs that sit between the rotator cuff ligaments and the underlying bone.
3. Tears: Caused by overuse or trauma of the rotator cuff (fall, accident, or extreme strain). Rotator cuff tears can be partial (tendon is still somewhat attached to the bone) or complete (tendon has separated completely from the bone).

The following factors may increase the risk of having a rotator cuff injury.

• Age: As people get older, the risk of a rotator cuff injury increases. Rotator cuff tears are common in people over 60. 
• Occupations: Jobs such as carpentry or house painting require repetitive overhead, arm movements over time that can cause damage to the rotator cuff sleeve.
• Family history: Inherited tendon weakness may run in some families.

Not all rotator cuff injuries cause pain. Some are the result of degenerative conditions, which means the rotator cuff could be injured for quite a long time before symptoms begin to show up.

In general, signs and symptoms of rotator cuff injury include:

• Pain in the shoulder that worsens at night
• Pain in the shoulder that worsens with certain movements, such as reaching overhead
• Loss of full range of motion of the affected shoulder (i.e. inability to reach behind the back)
• Trouble sleeping on the affected shoulder
• Progressive weakening of the shoulder

Treatments range from resting the affected arm to medical procedures like surgery. Tendinitis can advance to a cuff sleeve tear, and the injury can deteriorate with time. Seeking treatment as soon as the symptoms are noticed helps keep the injury from advancing.

Nonsurgical treatments include:

• Resting the affected arm and wearing a sling to isolate arm movements
• Applying hot or cold packs to the affected shoulder to reduce inflammation
• Physical therapy and exercises to recover strength and range of motion
• Injecting the affected area with cortisone, a steroid that helps reduce inflammation
• Over-the-counter anti-inflammatory medications, such as ibuprofen and naproxen

Daily stretching and exercising may help strengthen the rotator cuff and prevent the risk of injury.

Most exercises for a torn rotator cuff work on the pectoral, shoulder, and upper arm muscles. However, it is important to also strengthen the muscles of the upper back (trapezius) as well as the muscles around the shoulder bone to stabilize the joint from all sides. Your primary care physician or a physiotherapist can assist with this.