Rotator Cuff Tears: Stranger Than You’d Think

A close-up, photorealistic medical illustration of a human shoulder joint with a semi-transparent overlay showing the rotator cuff tendons. The image is set against a smooth gradient background transitioning from deep navy to white, with soft, clinical lighting that creates a calm and professional appearance.

No doubt about it, rotator cuff tears can be confusing. It’s not that you can’t understand the idea of having a tear in your tendon. That’s easy.

It’s just that treating them can be counterintuitive: some get better with therapy and others don’t. Some cause significant pain and others don’t. Some need surgery and others don’t.

What a New Study Revealed About Rotator Cuff Pain

A new study on rotator cuff tears is no less counterintuitive.

The study demonstrated that if you have a rotator cuff tear that was not caused by trauma (atraumatic), there is no link between the amount of pain you experience and the size of your tear.

Strange right?

Intuitively you would think that the larger a rotator cuff tear is, the more painful it would be. But that was not the case.

So What Actually Predicts Pain?

The goal of the study was to figure out whether there are certain factors that cause rotator cuff tears to be painful in some people and not others. They examined a number of potential variables — size being one of them.

The three most important factors that predict pain in atraumatic full thickness rotator cuff tears are: educational level, race, and whether you have a large number of other health problems.

In other words if you have a full thickness atraumatic rotator cuff tear, have a high school education, are Black, have multiple medical problems and you have an atraumatic rotator cuff tear, you have a higher chance of having pain.

Why This Finding Matters for Buffalo-Area Patients

In some ways this is a frustrating finding for both patients and surgeons alike. The factors that seem to correlate with pain are not what we would consider modifiable risk factors. That is, we can’t do anything about them — not in the short term at least.

To me this study emphasizes that there is still a tremendous amount of art to medicine. It also drives home the point that even when treating something as specific as a rotator cuff tear, we are treating a person whose entire background including race, education and family support system factors into why they may be seeking treatment.

Knowing your patient is critical.

Related Resources From Dr. DiPaola

Rotator cuff care is layered. The links below are offered as a starting point.

Serving Western New York — Schedule a Consultation

Shoulder pain is experienced differently by every patient across the Buffalo-Niagara region. A personal evaluation is the only way to understand what your tear means for you.

Need help understanding your shoulder problem? Call 716-204-3200 or Schedule a consultation with Dr. DiPaola to explore your options