Unfortunately, a rotator cuff tear will not heal on its own. If a patient has a full thickness rotator cuff tear, if they’re active, generally the treatment for that would be to fix it because it will not heal itself. If you don’t fix it, then the problem is that not only can a patient have persistent pain and weakness, quite frankly, very limited function of their arm or of their shoulder, but they can ultimately develop what’s called rotator cuff arthropathy. What rotator cuff arthropathy is: the humeral head is maintained within the socket (which is the Glenoid) by a series of ligaments and also by the rotator cuff. So if all or (more commonly) a portion of your rotator cuff is torn off of the bone, it scars down. Sometimes it gets to the point where it cannot be brought back over and then it gets to be too late, so you can’t repair it anymore. The problem with that is if your rotator cuff tendon is retracted and scarred down, it’s not acting as a stabilizer of the shoulder. So then what happens is the humeral head starts to migrate up, starts to shift up out of the joint, and that alters the biomechanics of the shoulder joint. Because of that, patients develop arthritis because the biomechanics (the way the shoulder joint works) is out of whack and it causes degeneration of the cartilage, which leads to even more pain because then patients have a rotator cuff tear that’s not repairable and bad arthritis in their shoulder. That’s a very difficult problem.
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