Can My Partial Rotator Cuff Tear Get Bigger?

Many people ask me, “Can my small rotator cuff tear get bigger over time?” Some patients put off getting their rotator cuff tear treatment for years. Is there a risk? Let’s go over it.

What is a Shoulder Rotator Cuff?

There are four muscles in your shoulder. These act to stabilize and allow movement of the

diagram showing the muscles in a shoulder

shoulder joint. The tendons of these muscles can become torn either through trauma or wear and tear. This tear is called a rotator cuff tear. The tear can be small, or partial, meaning the tendon isn’t torn all the way through.

Will the Tear Get Bigger if Not Treated?

If you have a partial tear, will it get bigger? Or does it just get better on its own? If it does get bigger, how long does it take before it completely ruptures?

Let’s take a look at a recent study. This is a “meta-analysis” – considered the king of studies as it takes data from multiple studies and aggregates it to perform a deeper analysis.

chart showing rate of progression to a full-thickness tear

The graph above is from a newer study. They plotted the different study results over time as a percentage increase in the tear versus time. The rotator cuff tears got bigger at about 5% over 10 months and by 20 months they were approximately 10% bigger. It took about 5 years to get 20% bigger.

Should You Care?

At Nashville Regenerative Orthopedics, we can treat rotator tears with precise ultrasound-guided injections of orthobiologics. For small rotator cuff tears, platelet-rich plasma (PRP) is a good fit. For larger tears, then bone marrow concentrate would be a better fit. If they’re completely torn and retracted (pulled back like a rubber band), they will not heal on their own. But even in this case you can still decrease pain and improve function with proper applications of regenerative medicine.

So, depending on the severity of your rotator cuff tear, you may have limited time to avoid surgery. If you have a tear at say 25%, then you may have some years to get it treated with PRP. If your tear is already 50%, you would want to get that treated as soon as possible.

To Summarize

As with any condition, early detection and treatment are always better. Putting off treatment could increase the amount of treatment needed and lower your chance of avoiding surgery altogether.

So, will your partial shoulder tear (or rotator cuff tear) get bigger? The answer is yes. Will the tear progress rapidly? Not likely, per recent studies. However, delaying treatment with any condition often proves to be an expensive and often regretful choice.

Dr. Ethan Kellum, M.D.

Nashville Regenerative Orthopedics

dr ethan kellum

NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.