Back to Home
Shoulder Condition

Rotator Cuff Tears

Specialist assessment and treatment — from non-surgical management and physiotherapy through to arthroscopic keyhole repair.

Book a Consultation Call 020 7770 8185
Overview

What is a Rotator Cuff Tear?

The rotator cuff is a group of four muscles and their associated tendons that wrap around the shoulder joint. Together they stabilise the ball within the socket of the shoulder, and allow the arm to be lifted, rotated, and controlled during overhead activities. A rotator cuff tear occurs when one or more of these tendons is partially or fully disrupted.

Tears may be traumatic — caused by a fall, a sudden forceful movement, or a direct impact — or degenerative, developing gradually over time as the tendon tissue ages and weakens. Degenerative tears are more common and typically affect people over the age of 50, though they can occur at any age in people who perform repetitive overhead activities.

Types of Tear

Types of Rotator Cuff Tear

Partial-thickness tears

The tendon is damaged but not completely disrupted. Many partial tears can be managed successfully without surgery, particularly in patients with lower functional demands or where symptoms are manageable.

Full-thickness tears

The tendon is torn completely through, creating a hole or gap in the cuff. Full-thickness tears vary considerably in size — from a small split to a massive tear involving multiple tendons. The size and location of the tear, alongside the patient's age, activity level, and symptoms, all inform the most appropriate treatment approach.

Massive cuff tears

Two or more tendons involved

Tears involving two or more tendons are classified as massive. These may require more complex surgical reconstruction, and in some cases where primary repair is not possible, alternative reconstructive procedures may be considered.

Symptoms

Symptoms

Symptoms of a rotator cuff tear can range from mild discomfort to severe, disabling pain. Common features include:

Pain in the shoulder and upper arm, often worse at night

Weakness when lifting the arm or carrying objects

Difficulty reaching behind the back or overhead

A catching or clicking sensation in the shoulder

Gradual worsening of symptoms over time in degenerative tears

Some full-thickness tears — particularly degenerative ones — can be surprisingly painless initially, only becoming symptomatic after a seemingly minor incident.

Diagnosis

Diagnosis

Accurate diagnosis is essential before any treatment decision is made. Professor Kochhar's assessment includes a thorough clinical examination to evaluate shoulder strength, range of movement, and specific tests for rotator cuff integrity. This is supported by imaging — typically an MRI scan, which provides detailed information about the size, location, and tissue quality of any tear, as well as the condition of surrounding structures.

Ultrasound is also used in certain clinical scenarios and allows dynamic assessment of the rotator cuff in real time.

Treatment

Treatment Options

Non-Surgical Management

Not all rotator cuff tears require surgery. Many patients, particularly those with partial tears or smaller full-thickness tears and manageable symptoms, can be treated effectively with a combination of physiotherapy, activity modification, and injection therapy where appropriate. Professor Kochhar takes a considered, patient-centred approach — the goal is always to find the least invasive treatment that achieves the best outcome for that individual.

Rotator Cuff Repair

Arthroscopic Keyhole Surgery

Surgical repair is recommended when non-surgical treatment has not achieved adequate improvement, when the tear is large and causing significant functional limitation, or when early repair offers a meaningfully better long-term outcome — particularly in younger, active patients with an acute traumatic tear.

Professor Kochhar performs rotator cuff repair arthroscopically (keyhole surgery). This minimally invasive approach allows the torn tendon to be reattached to the bone using small anchors, with significantly less trauma to surrounding tissue than open surgery. Arthroscopic repair is associated with lower complication rates, faster recovery, and excellent outcomes in appropriately selected patients.

Rehabilitation

Recovery from rotator cuff repair requires structured, staged rehabilitation. Professor Kochhar works with specialist physiotherapists to provide a bespoke rehabilitation protocol for each patient. The shoulder is typically immobilised in a sling initially to protect the repair, and progressive strengthening is introduced over the following weeks and months. Full recovery — including return to sport or heavy manual work — generally takes between four and nine months depending on tear size and individual factors.

FAQ

Frequently Asked Questions

Full-thickness tears do not heal spontaneously — once the tendon is completely disrupted, the gap cannot close without surgical intervention. However, many people with full-thickness tears live comfortably and function well without surgery, particularly if the symptoms are mild and the compensating muscles are strong. Partial tears may stabilise with appropriate rehabilitation.

Most patients are in a sling for four to six weeks following surgery, depending on the size of the repair. Gentle movement begins early, and progressive strengthening follows. Return to desk work is typically possible within a few weeks; return to sport or heavy lifting may take six to nine months. Professor Kochhar provides a realistic, personalised timeline at the point of surgical planning.

This depends on the tear type, size, and the individual. Some tears remain stable and manageable for many years. Others progress in size over time. In general, early specialist assessment allows better-informed decisions — including whether watchful waiting is appropriate or whether timely repair would preserve a better long-term outcome.

In experienced hands, arthroscopic rotator cuff repair achieves equivalent or better outcomes compared to open repair, with the significant advantages of less post-operative pain, reduced infection risk, and faster recovery. Professor Kochhar specialises in arthroscopic techniques and has extensive experience in complex reconstructions.

Why Choose Professor Kochhar

Expert Care You Can Trust

Professor Tony Kochhar is a specialist shoulder and upper limb surgeon with extensive experience in the diagnosis and surgical management of rotator cuff pathology, including complex and revision cases. He is FRCS (Tr. & Orth) qualified, a member of the British Orthopaedic Association, and sees patients privately at London Bridge Hospital and across the West Kent area.

His founding principle is that an early, accurate diagnosis leads to a faster recovery — and that surgery, when it is the right answer, should be performed by an expert.

Book a Consultation Call 020 7770 8185

Ready to Move Without Pain?

Call us on 020 7770 8185 or complete our contact form and we'll arrange an appointment at a clinic near you.

Book a Consultation Call 020 7770 8185