A rotator cuff tear might start with mild shoulder pain, but if left untreated, it can turn into a serious problem. At Steven Struhl, MD – Shoulders & Knees, with offices in NYC and Westchester, NY, we often see patients who have delayed treatment, only to face more complicated injuries later. Ignoring a rotator cuff tear doesn’t make it go away — it almost always makes it worse. Understanding the risks of leaving a tear untreated can help you make the right decision for your long-term health.
Damage Gets Worse Over Time
Rotator cuff tears don’t heal on their own. In fact, studies show that about 40% of partial tears will get larger over a period of just two years if left untreated. A small tear can easily grow into a large one, making it much harder to repair later. As the tear enlarges, shoulder strength and mobility continue to decline, often leading to chronic pain that disrupts daily activities.
Risk of Frozen Shoulder
One of the lesser-known risks of ignoring a rotator cuff injury is developing frozen shoulder (adhesive capsulitis). When your shoulder hurts, you naturally avoid moving it — but that lack of movement can cause the joint capsule to stiffen and tighten. Frozen shoulder significantly limits your range of motion and can take months or even years to fully resolve, often requiring aggressive physical therapy or surgical intervention.
Frozen shoulder is particularly common in people aged 40 to 60, and it can be even more debilitating than the original rotator cuff tear if not properly addressed.
Muscle Atrophy and Fatty Degeneration
Another serious consequence of untreated rotator cuff tears is muscle atrophy and fatty degeneration. When the rotator cuff muscles are not used properly because of a tear, they begin to shrink and weaken. Over time, healthy muscle tissue is replaced by fat — a process that can make successful surgical repair far less likely.
Research shows that after a significant period (sometimes as little as six months), rotator cuff muscles can undergo changes that are irreversible. This means even if surgery is performed later, the outcomes may not be as strong, and full function may never return.
Increased Risk of Arthritis
Chronic rotator cuff tears also put extra stress on other parts of the shoulder joint, which can lead to rotator cuff arthropathy — a type of shoulder arthritis caused by a worn-out rotator cuff. Patients with rotator cuff arthropathy often experience constant pain, weakness, and a grinding sensation when they move their arm. Treating this condition can require more invasive procedures like shoulder replacement surgery, rather than simple rotator cuff repair.
Early Treatment Offers the Best Outcomes
The good news is that early diagnosis and treatment lead to far better results. Many small tears can be successfully treated with physical therapy, injections, or minimally invasive arthroscopic surgery. Addressing the issue early can prevent more serious complications, preserve your shoulder function, and reduce the chances of needing major surgery down the line.
At Steven Struhl, MD – Shoulders & Knees, we specialize in advanced, patient-focused care for rotator cuff injuries. Whether you’re dealing with a recent tear or lingering shoulder pain, we can help you find the right solution to protect your health and your future.
Don’t wait — if you suspect a rotator cuff injury, contact us today to schedule a consultation at our NYC or Westchester offices.
