From Codman to Neer
Boston surgeon Ernest Codman documented supraspinatus ruptures from around 1911 and summarized them in his 1934 book The Shoulder (Codman, 1934). In 1972 Charles Neer proposed that tendons were pinched under the acromion ('impingement') and introduced acromioplasty (Neer, 1972). Age-related degeneration is now seen as the bigger driver.
Common, and often painless
Ultrasound of 411 pain-free volunteers found tears in 23%, and in over half of those 80 and older (Tempelhof et al., 1999). In a Japanese village of 1,366 people, about 20.7% had a tear (Yamamoto et al., 2010). An MRI finding alone does not prove it is the source of your pain.
Symptoms and frozen shoulder
Night pain when lying on the side, pain mid-way through lifting the arm, trouble reaching overhead or behind the back, and weakness in larger tears are typical. In frozen shoulder the joint is stiff even when someone else lifts the arm; with a cuff tear passive motion is usually preserved.
Treatment choices
AAOS recommends trying rest, anti-inflammatories and physical therapy first for most degenerative tears. A Finnish trial found physiotherapy alone matched surgery at one year for small non-traumatic tears in people over 55 (Kukkonen et al., 2014); a Norwegian trial found modestly better results with surgery for small and medium tears (Moosmayer et al., 2010). Acute traumatic tears in younger people and large tears are stronger surgical candidates.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Can a torn rotator cuff heal on its own?
- Full-thickness tears rarely reattach, but strength training often restores function and eases pain.
- How long is recovery after surgery?
- Usually several months including a sling period and staged rehab.
Sources reviewed: 2026-11-02
References
- Codman, E. A. (1934). The shoulder: Rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Thomas Todd. The classic that first described supraspinatus tears in depth.
- Neer, C. S., II. (1972). Anterior acromioplasty for the chronic impingement syndrome in the shoulder: A preliminary report. The Journal of Bone & Joint Surgery, 54(1), 41–50. Introduced impingement and acromioplasty.
- Tempelhof, S., Rupp, S., & Seil, R. (1999). Age-related prevalence of rotator cuff tears in asymptomatic shoulders. Journal of Shoulder and Elbow Surgery, 8(4), 296–299. Tears are common in pain-free shoulders as people age.
- Yamamoto, A., Takagishi, K., Osawa, T., Yanagawa, T., Nakajima, D., Shitara, H., & Kobayashi, T. (2010). Prevalence and risk factors of a rotator cuff tear in the general population. Journal of Shoulder and Elbow Surgery, 19(1), 116–120. About one in five villagers had a tear.
- Moosmayer, S., Lund, G., Seljom, U., Svege, I., Hennig, T., Tariq, R., & Smith, H.-J. (2010). Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff. The Journal of Bone and Joint Surgery. British Volume, 92-B(1), 83–91. Randomized trial of surgery vs physiotherapy.
- Kukkonen, J., Joukainen, A., Lehtinen, J., Mattila, K. T., Tuominen, E. K. J., Kauko, T., & Äärimaa, V. (2014). Treatment of non-traumatic rotator cuff tears: A randomised controlled trial with one-year clinical results. The Bone & Joint Journal, 96-B(1), 75–81. Physiotherapy alone matched surgery at one year for small degenerative tears.
- American Academy of Orthopaedic Surgeons. (n.d.). Rotator cuff tears. OrthoInfo. AAOS patient guide to symptoms and treatment.