The mobility and stability of your shoulder are ensured by the combined action of different muscles that constitute the rotator cuff, so-named as these muscles come in a way "cap" the head humeral.
When the tendons, which tie the muscles to the bones of your joint, are damaged, the normal function of your shoulder is difficult.
The humeral head can no longer rotate properly around its center of rotation, it may tend to rise and come in contact with the acromion, creating a subacromial impingement.
Some patients are more hampered by functional limitation, others by pain, but this is not related to the severity of your condition : some massive ruptures can be relatively painless while more superficial inflammations can be more painful.
There are different stages of severity in rotator cuff tears : partial or superficial tears, which do not penetrate the tendon, and complete or transfixing tears.
Below, an animation to better understand the mechanism of rotator cuff tear (in French)
The treatment will depend on the severity of the lesions but also the use you make of your shoulder as in your professional, sport or leisure practice.
To establish an effective diagnosis your surgeon will need an X-ray as well as an ultrasound or MRI to assess the condition of the tendons.
In first instance, pain and inflammation can be controlled by analgesics and anti-inflammatories medications. Appropriate rehabilitation will also help to restore shoulder flexibility and develop compensations for other unreached muscles. These medical treatments can sometimes suffice to relieve you durably ; nevertheless a torn tendon cannot heal naturally.
The first operative stage consists in releasing the acromial space, the second time in repairing the damaged tendons.
When cuff tears cannot be repaired because they are too old, too wide or too retracted, the surgical procedure of subacromial decompression under arthroscopy, can relieve the painful phenomena linked to the subacromial impingement.
In all cases appropriate rehabilitation should be conducted with seriousness and motivation to achieve the best possible long-term outcome