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Can a Rotator Cuff Tear Heal On Its Own?

Do you have shoulder pain? Are you suspecting a muscular injury like a rotator cuff tear? Can a rotator cuff tear heal on its own?

Maybe you felt a sharp pain or heard a pop while hitting your PR on your overhead squat or press, or you worked a job that has you lifting heavy boxes or reaching repetitively overhead. Now there’s a sharp, pinching pain at the top of your shoulder, even while sleeping at night.  

Yep – you may have injured your rotator cuff!

What exactly is your rotator cuff and what can you do about it other than surgical intervention?

First, Understand Rotator Cuff Anatomy


The rotator cuff, commonly abbreviated as RTC, is a group of 4 muscles located on your shoulder blade which attach to the upper part of your arm. They are responsible for holding your humerus in place, elevating your arm overhead, and rotating the shoulder outwards. The RTC basically stabilizes your shoulder.

These muscles can be remembered by the acronym “SITS”

  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis

If any of these muscles are strained, torn, or have inflamed tendons, you could experience pain, weakness, and an inability to lift your arm. 

Images courtesy of Complete Anatomy

Pain can sometimes refer down the side of your arm or even into your hand which can be confused with nerve issues. This type of pain can develop from trigger points, inflamed muscles, or a tear.

The most common ways to injure your rotator cuff include:

  • performing overhead tasks
  • causing repetitive stress to your shoulder during throwing and racquet sports
  • participating in contact sports with direct trauma
  • experiencing wear-and-tear over time from poor shoulder girdle alignment and mobility

Symptoms can vary depending upon severity and can include a strain (pulled muscle), partial tear, or full-thickness tear. 

A rotator cuff strain or partial tear will typically heal over time with proper care. That includes physical therapy. Recovery time often depends on depth and location of tear.

A full-thickness rotator cuff tears will usually warrant a follow-up with an orthopedic specialist, and if confirmed by an MRI, may require surgical intervention.

Other common issues associated with rotator cuff injuries are as follows:

  • Shoulder Impingement Syndrome – Also called subacromial pain syndrome (SAPS). This injury to the RTC muscles or tendons causes the humeral head to butt-up against structures such as the subacromial bursa (fluid-filled sac which prevents the RTC muscle tendons from rubbing against bony areas) or acromion. 
  • Subacromial Bursitis – This is inflammation of the bursa in the shoulder. It is commonly treated by steroid injections or oral steroids, but typically requires physical therapy to restore full range of motion of the shoulder and strength of the rotator cuff to prevent recurrence.
  • Superior Labral Tear in Anterior-Posterior Direction (SLAP Tear) – This is a type of tear to the cartilage in the shoulder. The glenoid labrum is a fibrocartilage disc which deepens the glenoid fossa to improve stability of the shoulder joint. A stable shoulder prevents ligament sprains, muscle strains, or dislocation with injury. However, there is a vulnerable spot where the long head of the biceps tendon attaches along the cartilage in the shoulder. When that’s torn, it’s called a SLAP tear.

    Common causes of SLAP tears include: a motor vehicle accident, a fall onto an outstretched arm, or rapid pulling/forceful movement of the arm due to heavy weight or a sports-related injury.

    Those with any labral tear may experience a sensation of locking, popping, clicking, or grinding as well as a feeling that the shoulder may “pop out” along with loss of range of motion and weakness.

Next, Understand Shoulder Girdle Mechanics and The Rotator Cuff’s Role


The shoulder girdle complex is made up of the clavicle (collar bone), humerus (upper arm bone), and scapula (shoulder blade). 

These bones form several joints in the shoulder girdle:

  • Glenohumeral joint (the shoulder, which is where the shoulder blade and humerus meet)
  • Acromioclavicular joint (where the shoulder blade and collarbone meet)
  • Sternoclavicular joint (where the sternum and collarbone meet)
  • Scapulothoracic joint (a floating joint where the shoulder blade moves along the rib cage)

Together, these joints move to produce the shoulder movements known as flexion (raising your arm out in front of you), extension (reaching behind you), abduction (raising your arm out to the side), adduction (bringing the arm to your side), internal rotation (reaching behind your back), external rotation (reaching over your head and behind your back), and horizontal adduction (reaching across your body), and horizontal abduction (reaching out to the side). 

Without proper engagement of the rotator cuff muscles to assist in providing smooth and controlled motion of the shoulder joint, compensations can occur at the other joints within the shoulder girdle complex resulting in further injury to the passive tissues that stabilize the shoulder girdle complex (ligaments, the glenoid labrum, or bony attachments), and/or active tissues (muscles) such as the biceps.

So, Can a Rotator Cuff Tear Heal On Its Own?


Yes! Rotator cuff tears are frequently seen in a physical therapy clinic. Small rotator cuff tears can heal on their own with the right guidance. At JACO Rehab, physical therapists can help guide you to success!

The first session will always consist of a thorough evaluation to assess your range of motion, strength, and individual limitations, and is aimed at better understanding the underlying cause of your shoulder pain and/or weakness and how we as physical therapists can get you back to feeling 100%. 

Things to keep in mind for your first session:

  • Arrive early to fill out any necessary paperwork and have your ID and insurance card ready. 
  • Wear athletic clothing, and if comfortable, something sleeveless so your physical therapist can assess the tissues and joints hands on as well as see the quality of your motion.
  • Think about your goals. What is it that you want to achieve/do during and after physical therapy? 
  • Make sure to ask a lot of questions! We are here to help you not only by treating your injury directly, but by making you an integral part of your rehab team which includes knowing the how and why the exercises we are prescribing are addressing your issues. 

Typical course of care for a RTC injury will vary depending upon severity, location, and your own medical history/underlying conditions that can influence healing (smoking, diabetes). Expect to see a physical therapist for at least 4-6 weeks, twice per week. 

Physical therapists check all the surrounding joints to make sure the whole complex is moving appropriately. We look at your active mobility, passive mobility, joint play, strength, and how you move when you’re lifting/reaching/pulling/pushing. Treatment depends on how these factors look and feel.

Treatment sessions usually include hands-on manual therapy which allows the therapist to address any tissue or joint mobility restrictions that may be present. Sessions also include stretches and exercises that are important for your recovery, and they often reinforce the manual techniques that therapists perform. Your compliance to the prescribed exercises is your key to success – so come ready to work! 

By taking measurements at the beginning and end of each session, your physical therapist can ensure that the interventions prescribed are working for you. They are always individualized to meet your specific goals such as getting back to work, surfing, or golfing! 

Two Easy Exercises for Rotator Cuff Tears


Here are two examples of gentle exercises that a physical therapist may prescribe to treat your rotator cuff early in care. Use these as preliminary exercises before you get to a therapist. Do not perform if they are painful. 

 

  • Passive Table Flexion Stretch: This exercise emphasizes the range of motion needed to get back to activities overhead. All you need is a table or counter. It can be done standing or seated. The goal is to keep your shoulder down and back with your neck relaxed while bowing down to stretch your arms overhead. Avoid any pain or pinching in the shoulder – if you feel it, you may be going too far into the stretch.
  • Shoulder External Rotation Activation: This exercise works the rotator cuff, specifically the external rotators (Infraspinatus and Teres Minor). It can be performed on your back, sitting, standing, or on your side. Be sure to keep your chest up, squeeze your shoulder blades together, and keep your elbows to your side to isolate the right spot. This exercise is highly modifiable. External rotation can be done with a dowel as a stretch into the position, pushing into a towel as an isometric activation exercise, or with a resistance band/weight for strengthening.

We wish you the best of luck with your recovery. To schedule an appointment with use please call (808) 381-8947 or email us!

Written by Jenn Lewis, DPT

Contact Jaco

Call: (808)381-8947

Send An Email: scheduling@jacorehab.com