For the right shoulder, yes.
For many others, a good exercise program does just as well, without the months in a sling.
The biggest dividing line is HOW the tear happened. A tear from a sudden injury, with real weakness, often does best with repair, and sooner rather than later. A tear that crept up with age usually gets better with physical therapy. About 3 in 4 people with that kind of tear avoid surgery.
Age matters next. The older you are, the less likely a repair is to hold, and the smaller the gain over exercise tends to be. The decision is yours, made with your surgeon, and there’s rarely a right answer for everyone.
Who tends to do well with repair
- A tear from a fall, a heavy lift or a dislocation, with sudden weakness lifting or turning the arm out. Many surgeons prefer to repair these within weeks rather than many months, before the tendon pulls back and the muscle wastes. Exactly how soon is still debated
- Younger, active people with a full tear. Over the long term, repair tends to do better than exercise alone in this group
- A tear that’s getting bigger on repeat scans, while the muscle is still healthy
- Pain and weakness that haven’t budged after a proper exercise program of several months
Who tends to do well without it
- Wear-and-tear tears that came on slowly, especially over about 55. In trials of older people with small tears like this, repair added little over physical therapy, even five years on
- Partial tears, where the tendon is frayed but still attached to bone
- People whose main problem is pain, not weakness. Pain often settles with exercise even when the tear stays the same
- Anyone who can’t manage the rehab right now, because of work, caring duties or other health problems. A repair that isn’t protected in the first weeks can fail
Choosing exercise first rarely closes the door. If it doesn’t work after a fair try, surgery is usually still possible. The exception is the sudden tear with real weakness, where waiting too long can make repair harder.
See rotator cuff tear for what your scan result means.
The question isn’t just whether the tendon can be fixed. It’s whether fixing it will make your shoulder better than exercise would.
Will the repair hold?
This is the part people aren’t always told.
A repaired tendon doesn’t always stay attached. The stitches hold it to bone while it heals, and in some people it pulls away again, usually in the first months.
- Age is the biggest factor. The chance of the repair not holding roughly DOUBLES between 50 and 70
- Bigger tears fail more often. Small tears in younger people usually heal. Very large tears in older people often don’t fully heal
- Muscle quality matters. If the muscle has already turned partly to fat on your scan, that doesn’t reverse after repair
- Smoking and poorly controlled diabetes both make healing less likely
- A retear isn’t always a disaster. Many people still have less pain and better use of the arm than before surgery, even when the scan shows the tendon has come away again
What recovery costs you in time
Repair is the start of the recovery, not the end of it. Here’s what most people can expect. Your surgeon’s plan comes first.
- Weeks 0 to 6: sling most of the day and often at night. One arm for dressing, washing and cooking. Sleep is usually broken for the first few weeks. See rotator cuff surgery recovery week by week
- Driving: not while you’re in the sling or on strong painkillers. For many people that’s several weeks
- Desk work: often within a few weeks, if you can get there safely and the job allows it
- Lifting, overhead and manual work: usually four to six months, sometimes longer
- Full recovery: about four months for small tears, six months for large ones, and up to a year for massive tears
- Stiffness along the way is common and usually settles with work. See stiff shoulder after surgery
- Physical therapy for most of that time, with exercises at home most days
Physical therapy without surgery takes time too, usually several months. The difference is that you keep using the arm while you do it. The American Academy of Orthopaedic Surgeons has a clear overview of rotator cuff tear treatment options if you’d like the background.
Questions to ask your surgeon
- Did this tear come from an injury, or has it been building with age?
- How big is it, how far has the tendon pulled back, and how healthy is the muscle?
- At my age and with my tear, what’s the chance the repair will hold?
- What would you expect if I tried exercise first for three to six months?
- How long will I be in a sling, off work and unable to drive?
If you decide to go ahead, see how to prepare for shoulder surgery. For more questions worth asking, see questions to ask before orthopedic surgery.
See a doctor urgently if
- You suddenly can’t lift the arm or turn it outward after a fall or heavy lift
- You’re over 40, dislocated your shoulder, and the arm is still weak after a couple of weeks
- The shoulder is hot, red and swollen, or you have a fever
Get it checked if
- Night pain keeps waking you despite treatment
- The arm is slowly getting weaker, not just sorer
- Three to six months of a proper exercise program haven’t helped
A sudden tear with weakness often earns a repair. A slow tear with pain usually earns a fair try at exercise first.