Rotator Cuff Tear
What Is a Rotator Cuff Tear?
A rotator cuff tear is damage to one or more of the four tendons — the supraspinatus, infraspinatus, subscapularis, and teres minor — that attach the muscles around your shoulder blade to the top of your upper arm bone (humerus). Together, these tendons help stabilize the shoulder joint and allow you to lift and rotate your arm. A tear can be partial, where some fibers are still intact, or full-thickness, a complete tear through the tendon. It can happen suddenly from an injury or gradually from years of wear.
Is This You?
- You have shoulder pain that's worse at night or when reaching overhead
- You've noticed new weakness lifting, reaching, or rotating your arm
- You had a fall, a pull, or felt a sudden "pop" in your shoulder
- You've already been told you have a rotator cuff tear and want an honest read on your options
- Physical therapy hasn't resolved your symptoms and you want to know what's next
Symptoms
- Pain reaching overhead or behind your back
- Weakness lifting or rotating your arm
- Pain that disrupts sleep, especially lying on the affected side
- A cracking or catching sensation with certain movements
- In sudden injuries, a distinct pop or sharp pain at the moment it happens
Causes & Risk Factors
- Age-related wear — the most common cause of rotator cuff tears
- Acute injury — a fall onto an outstretched arm, a sudden pull, or a dislocation
- Repetitive overhead motion — common in throwing, swimming, and overhead work
- Prior shoulder injuries or untreated impingement
Non-surgical & Surgical Paths
Non-surgical first.
Many partial tears, and some full-thickness tears in lower-demand patients, improve significantly with physical therapy, activity changes, and anti-inflammatory treatment. We’ll always tell you honestly whether that’s a realistic path for your tear before recommending surgery.
Surgical repair — TendonSeam.
When surgery is the right call, TendonSeam is a knotless, trans-tendinous rotator cuff repair technique. Instead of the traditional method of individually tied knots and widely spaced anchors, TendonSeam creates a single continuous line of small closely spaced anchors joined by one continuous suture.
Compared with traditional repair methods, TendonSeam's construct is designed to provide a stronger repair and allow many patients to progress through recovery sooner.
Recovery & What to Expect
Recovery depends on the size of your tear and the repair performed, but here's the general path:
- Sling: With TendonSeam, patients are typically in a sling for ONLY 2.5 weeks on average — compared with the traditional 6 weeks required for standard anchor-and-suture repairs. Dr. Thon will tell you exactly when you're cleared based on your tear and repair.
- Physical therapy: For partial or standard repairs, PT typically starts within 1-2 weeks after surgery; for massive or revision repairs, PT is delayed about 4 weeks to protect the healing tendon. Many TendonSeam patients are able to begin gentle motion sooner — Dr. Thon will confirm your personal timeline.
- Follow-up visits: You'll be seen at least 6 times after surgery — at 2 weeks, 2 months, 4 months, 6 months, 8 months, 10 months, and 12 months.
- Overall timeline: Recovery is gradual — expect roughly 20% of your improvement in the first 3 months, and up to 80% by 6 months, with most patients reaching full recovery between 6 and 12 months.
Every recovery is different. Dr. Thon will walk you through your personal timeline in detail before and after surgery.
Why Choose Orchard Orthopedics for This
You'll always see Dr. Thon personally for your rotator cuff evaluation and surgery, not a resident or rotating provider. And if TendonSeam is the right fit for your repair, you get real, measurable advantages: a repair construct built to be twice as strong as native, healthy tendon and ten times more stable than traditional methods,[3] which is what allows most patients to spend only 2.5 weeks in a sling on average, instead of the traditional six. That's a stronger repair and a faster return to your life, paired with the direct access and unhurried follow-up care Orchard Orthopedics is built around.
In Their Own Words
“He took my rotator cuff that I was told was unrepairable and worked his magic. Repaired my rotator cuff. I now have no pain and more functionality in my shoulder. His attention to his patients is unmatched, very detail-oriented, with a great bedside manner. His expertise and concern for his patients is fantastic. I would recommend Dr. Thon to anyone seeking any orthopedic procedure.”
— Ben, 2021“I was referred to Dr. Thon by my primary physician when I tore my rotator cuff. This was the first time I'd ever needed surgery, and Dr. Thon went above and beyond to help prepare me for what to expect. When it turned out I also needed my labrum repaired, Dr. Thon made the correct call to work on both injuries and ensure my overall recovery time would be reduced. Post surgery, Dr. Thon has always been transparent regarding my progress and makes time to take any questions I may have, even outside of our scheduled visits. I highly recommend Dr. Thon.”
— TJ, 2022Frequently Asked Questions
Understanding Your Injury
Not every rotator cuff tear requires surgery. Treatment depends on the size and location of the tear, your symptoms, activity level, and your overall goals.
Some rotator cuff tears can become larger or more difficult to treat over time. An evaluation can help determine the best approach for your situation.
If symptoms continue despite physical therapy, further evaluation may help identify the underlying cause and determine whether another treatment option is appropriate.
Your treatment plan can be adjusted based on what is found during evaluation and imaging. We will explain your options and what each approach means for your recovery.
Deciding on Treatment
TendonSeam is a treatment approach designed to support tendon repair. Your physician can discuss whether it is appropriate for your specific injury.
Not necessarily. Every tear is different, and treatment depends on the size, location, tissue quality, symptoms, and other individual factors.
You should understand why surgery is being recommended, what alternatives exist, and what happens if you wait. A clear discussion of all options can help you make an informed decision.
It's completely reasonable to have concerns about surgery. Your consultation is an opportunity to discuss those concerns, alternatives, risks, and the expected recovery process.
Access, Cost & The Orchard Model
The cash-pay model allows more time for evaluation and discussion without insurance restrictions determining the structure of your visit.
Depending on your plan and applicable rules, HSA or FSA funds may be used for eligible medical expenses. We can provide the information you need to discuss eligibility with your plan administrator.
Referral requirements can depend on your circumstances and coverage. Contact the office to confirm what is needed before your visit.
Your care team will explain who you will see during your visit and how your evaluation and treatment will be handled.
Surgery & Recovery Logistics
Rotator cuff surgery is commonly performed as an outpatient procedure, although the exact plan depends on your individual circumstances.
Sling use varies depending on the type of repair and your surgeon's rehabilitation protocol.
Return to driving and work depends on your procedure, recovery, pain level, medications, and the physical demands of your job.
Recovery varies from person to person. Your rehabilitation plan and the specific procedure performed will determine your expected timeline.
Get an honest answer about your rotator cuff — and see if you're a candidate for the enhanced recovery of TendonSeam.
Less time in the sling. Faster rehab. A stronger repair.
Want the full picture on PRP, including the procedure and pricing? [ Visit our PRP & Orthobiologics page → ]
References
[1] Frix, J.T., et al. Tendon-to-bone seam technique: a knotless, transtendinous approach to arthroscopic rotator cuff repair. Arthroscopy, Sports Medicine, and Rehabilitation. DOI: 10.1002/atn2.70093.
[2] FDA 510(k) clearance, 2023.
[3] Integrity Orthopaedics (integrity-ortho.com).