The rotator cuff is a group of four muscles and tendons that support shoulder movement and stability. These tendons can sustain damage due to injury, ageing, or overuse, leading to partial or full-thickness tears. The difference between these tear types influences treatment and recovery.
This article explains the key distinctions between partial and full-thickness rotator cuff tears, covering symptoms, diagnosis, treatment, and recovery expectations.
How Do Partial and Full-Thickness Rotator Cuff Tears Differ?
Rotator cuff tears are classified based on the extent of tendon damage. Some injuries only affect part of the tendon, while others result in complete separation. These differences impact shoulder function and management approaches.
What Is a Partial-Thickness Tear?
A partial-thickness tear occurs when the tendon is damaged but not completely severed. It can affect the upper surface, undersurface, or middle portion of the tendon. The remaining intact fibres help maintain some movement and stability.
Characteristics of Partial-Thickness Tears:
- The tendon has some damage but remains connected to the bone.
- Pain occurs during certain arm movements, especially overhead activities.
- Shoulder strength may be reduced, particularly when lifting or rotating the arm.
- The joint retains a degree of function, but movement may feel restricted.
What Is a Full-Thickness Tear?
A full-thickness tear involves complete separation of the tendon, leaving a gap in the tissue. This disrupts shoulder mechanics, making arm movements significantly weaker.
Characteristics of Full-Thickness Tears:
- The tendon is fully detached from its attachment to the bone.
- Shoulder weakness is more pronounced, particularly when lifting objects.
- Overhead movements and daily tasks become increasingly difficult.
- Some individuals may experience clicking or catching sensations during movement.
Diagnostic Methods
Physical Examination: Assesses shoulder strength and range of motion to identify movement limitations and potential signs of a partial or full-thickness tear.
Magnetic Resonance Imaging (MRI): Provides a detailed view of the rotator cuff, showing whether the tear is partial (affecting part of the tendon) or full-thickness (completely separated).
Ultrasound Scan: Offers real-time imaging to evaluate the depth, size, and pattern of the tear, helping to distinguish between partial and full-thickness injuries.
Treatment Approaches
Treatment is based on the extent of the tear, severity of symptoms, and impact on daily function. Partial-thickness tears often improve with non-surgical management, while full-thickness tears may require surgery for full recovery.
Treatment for Partial-Thickness Tears
Physiotherapy: Strengthens surrounding muscles to improve shoulder function and reduce strain on the damaged tendon.
Activity Modification: Avoiding repetitive or forceful overhead movements reduces tendon stress and minimises tear progression.
Medication: Anti-inflammatory medication may be used to reduce pain and swelling during recovery.
Injections: Corticosteroid or platelet-rich plasma (PRP) injections may offer temporary pain relief in cases where symptoms persist.
Surgery: Surgery is generally not required unless the tear worsens or symptoms continue despite non-surgical treatment.
Treatment for Full-Thickness Tears
Surgery: Typically recommended for complete tendon separation, particularly in active individuals or those with significant weakness.
Rehabilitation: Post-surgical physiotherapy restores flexibility, strength, and shoulder stability.
Gradual Return to Activity: A structured recovery plan ensures safe progression back to daily tasks and reduces the risk of re-injury.
Ongoing Monitoring: Follow-up assessments track healing and long-term shoulder function.
Recovery Expectations
Healing time depends on the severity of the tear, treatment approach, and individual response to rehabilitation. Recovery timelines and rehabilitation goals differ between partial and full-thickness tears.
Partial-Thickness Tears: Recovery typically takes 6 to 12 weeks, depending on rehabilitation progress. Pain gradually improves with physiotherapy and movement exercises, which help restore shoulder function while reducing strain on the tendon. Regular follow-ups ensure healing stays on track and allow adjustments to prevent further damage.
Full-Thickness Tears: Post-surgical recovery takes 4 to 6 months, with a structured rehabilitation plan. In the early stages, movement restrictions protect the healing tendon and prevent re-injury. As recovery progresses, physiotherapy restores shoulder strength, flexibility, and function through controlled exercises.
Prevention Strategies
Although not all rotator cuff tears can be prevented, certain strategies may help reduce the risk of injury. A proper warm-up before physical activity prepares the muscles and tendons for movement, reducing strain. Regular shoulder-strengthening exercises improve stability and resilience, lowering the likelihood of tendon damage.
Using the correct technique during repetitive or overhead movements minimises unnecessary stress on the shoulder joint. Additionally, taking regular breaks during activities that involve prolonged or repetitive shoulder use helps prevent overuse injuries.
Conclusion
Partial and full-thickness rotator cuff tears differ in severity and management. While many partial tears respond well to physiotherapy, full-thickness tears often require surgical repair for full recovery. Early diagnosis and appropriate treatment help restore shoulder movement and prevent long-term limitations.
If you are experiencing shoulder pain or mobility issues, schedule an appointment today to discuss treatment options.