• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Shoulder and Elbow Doctor – Buffalo, NY

Live Receptionist for Appointments: M-F 9 am – 5 pm: 716-204-3200

Dr. Matthew DiPaola

Dr. Matthew DiPaola

Buffalo, NY Shoulder and Elbow Doctor

  • Home
  • About
    • Philosophy
    • Dr. DiPaola
    • Locations
    • Patient Testimonials
  • Learn more
    • Videos
    • Shoulder Problems and Treatments
    • Elbow Problems and Treatments
    • Dr. DiPaola’s Shoulder and Elbow Blog
    • FAQ
      • Why Choose a Shoulder and Elbow Specialist?
      • General Practice and Office Visit
      • A Quick Checklist of Treatment Related Questions for Your Doctor
      • General FAQs About Surgery
      • Shoulder Surgery
      • Shoulder Replacement
      • Reverse Total Shoulder Replacement
      • Hemiarthroplasty (Partial Shoulder Replacement) For Fracture
      • Rotator Cuff Repair
Contact

Do Rotator Cuff Tears Get Bigger Over Time?

I have noted in other posts that rotator cuff tears can cause a lot of confusion. 

Let’s assume that your doctor has diagnosed you with a rotator cuff tear.  He or she presents you with a few options: physical therapy, injections, surgery.  You have a small tear.  You are in a lot of pain, but you really haven’t tried any treatment yet and you’ve got a busy next couple of months coming up at work and your daughter is getting married in a month.  So you would like to avoid surgery at all costs right now. 

“Doctor,” you ask, “will this tear get bigger with time if I don’t surgery right away.

Good question.

Thankfully we have we have some research to guide us on this question. 

https://www-ncbi-nlm-nih-gov.gate.lib.buffalo.edu/pubmed/25609434

As it turns out “degenerative” rotator cuff tears, those arising with aging, do on average get bigger with time.  And the size of the tendon tear that you start with often dictates the likelihood that your tear will get bigger or stay the same.

In other words rotator cuff tears do tend to get bigger.  And the bigger yours is from the start, the higher chance you have of it tearing more. 

Why is this important?

We know that very large tears show more signs of degeneration.  Think of your rotator cuff tendons as fabric.  Larger tears are not only larger but often more “thread-bare” or worn out.  Worn out tissue doesn’t heal as well. 

So we can make a good case that smaller tears heal better and are more repairable or fixable were we to choose surgery.  It’s not to say that you have to have surgery.  It’s just that if you do choose that route, it may be more feasible when the tendon tear is smaller. 

What about timing?  Do rotator cuff tears enlarge right away or over years?

On average rotator cuff tears enlarge over about 2 years.  Of course not everyone is average.  But it’s a decent rule of thumb. 

So yes these tears often get bigger, but you do tend to have some time until they do.

Below are some conclusions from the study cited above.

  1. Patients with larger tear size on average had worse functional scores (different than pain, function means how well you move or how much strength you have).
  2. Patients with larger tear sizes did not necessarily have higher pain scores compared to patients with smaller tears
  3. 49% of tears enlarged with time with median time to enlargement of 2.8 years. 
  4. Final tear type predicted the probability whether a tear would get bigger.  61% of full thickness tears enlarged, 44% of partial thickness tears enlarged and 14% of controls went on to develop tears. 

Dominant shoulders with cuff tears had a higher chance of enlarging than non-dominant shoulders (63% to 42%)

  • 100 shoulders, 46% developed new pain with average time to develop pain at 2.6 years.
  • Tear enlargement is a risk factor for the development of pain (if you are getting pain again in your rotator cuff, and you have a known tear, it might be getting bigger).

Category iconDr. DiPaola's Blog,  Rotator Cuff Tag iconrotator cuff tear,  shoulder pain

Primary Sidebar

Recent Posts

  • American Shoulder and Elbow Surgeons Podcast: National Shoulder and Elbow Week.
  • How are Shoulders Like Onions?
  • The Arthroscopy and Simulation Lab at University at Buffalo: an inspiration for National Shoulder and Elbow Week
  • What are Multi Center Research Trials?
  • Where Does the Money Go?

Categories

  • Adolescents
  • Balloon Spacer
  • Decision Making
  • Dr. DiPaola's Blog
  • Elbow Problems and Treatments
  • Elbow Replacement
  • First Questions
  • Frozen Shoulder
  • General
  • MRI
  • Orthopedics
  • Physical Therapy
  • Rotator Cuff
  • Safety
  • Shoulder Arthritis
  • Shoulder Dislocation
  • Shoulder Fractures
  • Shoulder Labrum Tear
  • Shoulder Problems and Treatments
  • Shoulder Replacement
  • Sports Medicine
  • Uncategorized

Topics

Buffalo New York Canada lateral epicondylitis patients physical therapy and rotator cuff rotator cuff rotator cuff surgery rotator cuff tear shoulder pain shoulder replacement shoulder surgery smoking tennis elbow

Meet Dr. DiPaola

Matthew DiPaola MD 2020

Matthew DiPaola, M.D

Dr. DiPaola is a Board Certified Orthopedic Surgeon and shoulder and elbow specialist. He has attained extensive training in the treatment of shoulder and elbow conditions and dedicates his practice to treating shoulder and elbow dysfunction with the most advanced surgical and non surgical … Read more about Matthew DiPaola, M.D

Contact Dr. DiPaola

Please contact me for an appointment or … Click here for more options about Contact Me

Are You Confused About Rotator Cuff Tears?

What are they? What is the right treatment for your rotator cuff? Why did your brother-in-law get surgery for his and you are only doing therapy? If you’re reading this you may already know how painful rotator cuff tears are. You yourself may have difficulty sleeping or lifting your arm overhead. … Read more about Are You Confused About Rotator Cuff Tears?

  • YouTube

If you are looking to:

  • Find out why your shoulder won't stop hurting at night
  • Wake up energized from a good night’s sleep again
  • Know if your shoulder pain is a sign of something serious, or if you can safely ignore it
Click Here to Make An Appointment

At your visit I will personally see you and:

  • Listen to your unique needs and goals
  • Review your imaging tests
  • Perform a physical exam
  • Fully explain your options
  • Answer your questions
...and get you on the road to a better night’s sleep.

In Good Health,
Matthew DiPaola M.D.

Footer

Recent Video

https://www.youtube.com/watch?v=y8r2-I7xYzc

Useful Links

  • Shoulder Problems and Treatments
  • Frequently Asked Questions
  • Shoulder & Elbow Blog
  • Contact
  • Video

Phone

Appointments: 716-204-3200

Email

mdipaola@buffalo.edu

Address

4949 Harlem Rd, Amherst, NY  14221
Web Design
  • YouTube
Legal Disclaimer & Privacy Policy – Disclosure About TestimonialsCopyright Matthew DiPaola © 2025. All rights reserved.

Return to top