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What Is the Natural Course of Full-Thickness and Partial-Thickness Rotator Cuff Tears?

Are you plagued by shoulder pain that has now transitioned from intermittent to constant and keeps you up at night? Are daily shoulder movements, such as dressing and reaching for objects in the kitchen cabinets, painful? Is your range of motion decreasing as your pain is increasing? You may have a full- or partial-thickness rotator cuff tear.

Has conservative therapy in the form of heat, ice, stretching, rest, and acupuncture failed to provide significant relief?

Has an MRI demonstrated a full-thickness or partial-thickness tear of the rotator cuff? What to do?

What Is the Rotator Cuff?

The rotator cuff (shown above) is a group of four muscles and tendons that act to stabilize the shoulder. These muscles include the following:

  • Supraspinatus
  • Infraspinatus
  • Subscapularis
  • Teres Minor

What Is a Partial-Thickness vs a Full-Thickness Rotator Cuff Tear?

One or more of the four rotator cuff tendons or muscles may tear. Tears are classified and include a partial-thickness tear where only a portion of the tendon is torn, which is illustrated in the ultrasound image above, or a full-thickness tear where the tear extends across all five layers of the tendon.

What Is the Natural Course of a Symptomatic Full-Thickness or Partial-Thickness Rotator Cuff Tear?

Kim et al evaluated 122 patients with partial- and full-thickness supraspinatus tears that received nonsurgical treatment for rotator cuff tears. Tears were diagnosed by MRI. Mean follow-up was 24.4 months.  There were 27.9% of patients with full-thickness tears versus 72.1% with partial-thickness tears. Tear size increased 82.4% in patients with full-thickness tears and 26.1% with partial-thickness tears. The authors concluded that having a full-thickness tear was the most reliable risk factor of tear progression.

What to Do?

If left untreated, full-thickness and 26% of partial-thickness tears will progress. Patients run the risk that a rotator cuff tear can progress with the two edges of the tendon physically separating, which is termed retractions. Surgery is the only treatment option when this occurs. Beware, however, as rotator cuff tear surgery is associated with a high incidence of retears, which can exceed 75%.

Steroid Injection?

Steroids have been demonstrated to be highly toxic to tendons, cartilage, and muscle and should be avoided.

Platelet and Stem Cell Treatment!

At the Centeno-Schultz Clinic, we have over a decade of clinical experience treating rotator cuff tears with ultrasound-guided stem cell injections. The preliminary results of our ongoing randomized control study are reviewed below:

If you or a loved one suffers from ongoing shoulder pain from a rotator cuff tear that has not improved with conservative care, there is a good chance that it may progress. Rather than risk progression and possible retraction of the tendon, please schedule an evaluation at the Centeno-Schultz Clinic where you will be evaluated by a board-certified, fellowship-trained physician who will review your MRI, perform diagnostic ultrasound, and outline treatment options. Anything less may compromise your ability to get back into the game.

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