Rotator cuff tears are a common source of shoulder pain and dysfunction. Understanding the progression of these tears is crucial for determining appropriate treatment strategies. One factor that can influence the prognosis of rotator cuff tears is the extent of tendon involvement. This blog post will look into a study conducted by Matthewson et al. in 2015, which examined the relationship between tear size and the likelihood of tear progression over a period of 4.4 years.
The study by Matthewson et al. (2015) analyzed a cohort of patients with rotator cuff tears to determine the correlation between tear thickness and the likelihood of tear progression. The researchers found that in cases where the tear involved more than 50% of the tendon thickness, a significant 55% of the patients experienced tear progression over the 4.4-year follow-up period. This indicates that larger tears are more likely to progress and worsen over time, potentially leading to increased pain and functional limitations.
On the other hand, when the tear was less than 50% of the tendon thickness, the study found that only 14% of patients experienced tear progression during the same follow-up period. This suggests that smaller tears are less likely to progress and may remain relatively stable over time.

The findings of this study highlight the importance of assessing the extent of tendon involvement when diagnosing and managing rotator cuff tears. A tear encompassing more than 50% of the tendon thickness should raise concerns about potential progression and the need for appropriate interventions. On the other hand, tears involving less than 50% of tendon thickness carry a lower risk of progression and may require less aggressive treatment strategies.
In summary, the study by Matthewson et al. (2015) suggests that the extent of tendon involvement plays a significant role in the progression of rotator cuff tears. Tears involving more than 50% of the tendon thickness have a higher probability of worsening over time compared to tears measuring less than 50% of the tendon thickness. These findings emphasize the importance of early diagnosis, accurate assessment, and appropriate treatment planning for individuals with rotator cuff tears.
As always, reach out to a performance physical therapist to evaluate your symptoms and help you get back to your goals.
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Sieara
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