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A partial-thickness rotator cuff tear is a tear that goes only part of the way through one of the rotator cuff tendons, most often the supraspinatus at the top of the shoulder. The tendon is frayed or split but still attached to the bone, unlike a full-thickness rotator cuff tear. Partial tears are a common cause of shoulder pain, especially with overhead activity and at night. Dr. Andrew Dold, a board-certified, fellowship-trained sports medicine surgeon in Frisco, Texas, treats partial tears with therapy and injections first and, when needed, arthroscopic surgery, including the REGENETEN bioinductive implant.

On this page:Types · Symptoms · Diagnosis · Non-surgical care · Surgery · Recovery · FAQs · Research
At a glance

  • Partial tears are common, and many people have them without any pain
  • Most patients start with physical therapy, activity changes and, if needed, an injection
  • Partial tears do not heal on their own and can enlarge over time, so follow-up matters
  • Surgery depends on how deep the tear is: smaller tears are usually cleaned up (debrided), deeper tears are usually repaired, and some tears are treated with a collagen implant

Types of partial tears

Partial tears are described by where they are and how deep they go:

  • Articular-sided tears are on the underside of the tendon, facing the joint. This is a common location.
  • Bursal-sided tears are on the top surface of the tendon, facing the bursa under the acromion.
  • Intratendinous tears are inside the tendon.

Depth is usually graded as low (under about 25% of the tendon thickness), intermediate (25 to 50%) or high (over 50%). This grading guides treatment.1

Symptoms

  • Pain at the front or side of the shoulder, often spreading toward the upper arm
  • Pain when reaching overhead, behind the back or out to the side
  • Night pain, especially lying on the affected shoulder
  • Mild weakness or fatigue with overhead activity

Symptoms often overlap with rotator cuff tendinitis and shoulder impingement.

Diagnosis

Dr. Dold examines your shoulder motion and rotator cuff strength and checks for other sources of pain, such as the biceps tendon, the AC joint or a stiff shoulder. X-rays look at the bone shape and the AC joint, and an MRI or ultrasound shows the tear. Imaging findings must be matched to your symptoms: in an MRI study of people with no shoulder pain, 20% had a partial-thickness tear, and 26% of those over 60 did.2

Treatment without surgery

Most patients start with:

  • Physical therapy to strengthen the rotator cuff and shoulder-blade muscles and improve posture and mechanics
  • Activity changes, such as limiting heavy overhead lifting for a period
  • Anti-inflammatory medicine, if safe for you
  • An injection of cortisone or platelet-rich plasma (PRP) when pain limits therapy

In a randomized trial of 99 patients with partial tears or tendinopathy, both PRP and cortisone injections improved pain. PRP gave greater improvement in pain and function at 3 months, but there was no lasting difference at 12 months, and rates of later surgery were similar.3

Partial tears have limited ability to heal on their own. In a study that repeated imaging after about a year of non-surgical treatment, the tear enlarged in 21 of 40 shoulders and progressed to a full-thickness tear in 11, while 8 got smaller or disappeared.4 For this reason, Dr. Dold monitors symptoms and may repeat imaging if pain or weakness worsens.

Surgery

Surgery is considered when pain and function do not improve after a good trial of non-surgical care, usually several months. Factors include your age, activity level, which side of the tendon is torn and how deep the tear is.1 Arthroscopic options include:

  • Debridement: the frayed tendon is smoothed, often with a subacromial decompression. A systematic review found good results with debridement for tears involving less than 50% of the tendon, although some tears later progressed.5
  • Repair: for deeper tears (generally over 50%), the torn tendon is repaired to the bone, either in place (transtendon repair) or after completing the tear and repairing it like a full-thickness tear. Both methods have shown similar results.5,6 In a study with 5 to 6 years of follow-up, no patient needed revision surgery and 76% of active patients returned to the same or a similar level of activity.7
  • REGENETEN bioinductive implant: a thin collagen patch is placed on top of the tendon to support new tissue formation, without a full repair for many partial tears. In a prospective multicenter study of 33 patients with intermediate- and high-grade partial tears, shoulder scores improved at 1 and 2 years, MRI showed new tissue filling the tear in nearly all patients and tendon thickness increased.8 A 2024 review noted that these implants are promising but long-term data are still limited.9

Bursal-sided tears appear to do worse with debridement alone than articular-sided tears, so repair or augmentation may be favored for some lower-grade bursal-sided tears.6 Dr. Dold will explain which option fits your tear.

Recovery

Recovery depends on the procedure. After debridement or an implant without a full repair, most patients start motion right away and progress through therapy over several weeks to a few months. After a repair, the arm is protected in a sling for several weeks and full recovery usually takes several months. Dr. Dold will give you a specific plan. For more detail, see Rotator Cuff Tears and Repair: 43 Questions Patients Ask.

Watch Dr. Dold: partial-thickness tear repair

Some of these videos show real surgery, so some viewers may prefer not to watch.

Repair of a partial-thickness rotator cuff tear with the REGENETEN implant

More videos on Dr. Dold’s YouTube channel.

What the research shows

Here is what the research shows about partial-thickness rotator cuff tears.

Most partial tears do not need surgery

Partial tears progress to full-thickness tears slowly, at roughly 3% per year in pooled studies. Many patients improve with therapy and, if needed, an injection. A 2026 meta-analysis found that surgery gave slightly higher shoulder scores than non-surgical care, but the difference was smaller than patients typically notice, so surgery is reserved for persistent symptoms. Several meta-analyses suggest PRP injections can reduce pain, although results vary between studies.

Surgery depends on depth

Shallower tears generally do well with debridement alone, and a randomized trial found debridement and repair gave similar results for moderate bursal-sided tears. For tears deeper than about 50%, repair gives good results, whether the tendon is repaired in place or the tear is completed and then repaired. Routine acromioplasty is not supported.

Bioinductive collagen implant

Studies of the REGENETEN collagen implant for partial tears report thicker tendons and improved scores, and a small randomized trial favored the implant over a sutured repair. Long-term and independent high-level evidence is still limited. REGENETEN is made by Smith+Nephew, and Dr. Dold is a consultant for the company.

Why see Dr. Dold

  • Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
  • Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
  • Fellow of the American College of Surgeons (FACS), the American Academy of Orthopaedic Surgeons (FAAOS), the American Orthopaedic Association (FAOA) and the Royal College of Surgeons of Canada (FRCSC)
  • Author of a SLAP repair book chapter (Springer, 2017) and research on shoulder suture anchors (KSSTA, 2013)
  • Team physician and surgical consultant to Rugby Canada; has cared for professional athletes from the NFL, NBA, NHL, MLS, PGA Tour and Major League Rugby
  • D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google

Frequently asked questions

Will a partial rotator cuff tear heal on its own?

Usually not completely. Symptoms often improve with therapy, but the tear itself has limited ability to heal and can enlarge over time.4

Is PRP or cortisone better for a partial tear?

In a randomized trial, PRP gave more improvement at 3 months, but results were similar at 12 months.3 Dr. Dold will discuss which injection makes sense for you.

When is surgery needed?

When pain and function do not improve after several months of non-surgical care, or when the tear is deep or getting larger. The tear depth and location guide the type of surgery.1

What is the REGENETEN implant?

A thin collagen implant placed on the tendon during arthroscopy to support new tissue formation. Early studies are encouraging, but long-term data are limited.8,9

Can I keep exercising with a partial tear?

Often yes, with changes. A physical therapist can help you keep training while avoiding the movements that aggravate the tendon.

Do you accept my insurance?

Dr. Dold accepts most major insurance plans, including Medicare and Tricare. Please call 469-850-0680 to confirm your coverage.

Research cited on this page

  1. Plancher KD, Shanmugam J, Briggs K, et al. Diagnosis and Management of Partial Thickness Rotator Cuff Tears: A Comprehensive Review. J Am Acad Orthop Surg. 2021;29(24):1031-1043. PubMed
  2. Sher JS, Uribe JW, Posada A, et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995;77(1):10-15. PubMed
  3. Kwong CA, Woodmass JM, Gusnowski EM, et al. Platelet-Rich Plasma in Patients With Partial-Thickness Rotator Cuff Tears or Tendinopathy Leads to Significantly Improved Short-Term Pain Relief and Function Compared With Corticosteroid Injection: A Double-Blind Randomized Controlled Trial. Arthroscopy. 2021;37(2):510-517. PubMed
  4. Yamanaka K, Matsumoto T. The joint side tear of the rotator cuff. A followup study by arthrography. Clin Orthop Relat Res. 1994;(304):68-73. PubMed
  5. Strauss EJ, Salata MJ, Kercher J, et al. The arthroscopic management of partial-thickness rotator cuff tears: a systematic review of the literature. Arthroscopy. 2011;27(4):568-580. PubMed
  6. Katthagen JC, Bucci G, Moatshe G, et al. Improved outcomes with arthroscopic repair of partial-thickness rotator cuff tears: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2018;26(1):113-124. PubMed
  7. Vap AR, Mannava S, Katthagen JC, et al. Five-Year Outcomes After Arthroscopic Repair of Partial-Thickness Supraspinatus Tears. Arthroscopy. 2018;34(1):75-81. PubMed
  8. Schlegel TF, Abrams JS, Angelo RL, et al. Isolated bioinductive repair of partial-thickness rotator cuff tears using a resorbable bovine collagen implant: two-year radiologic and clinical outcomes from a prospective multicenter study. J Shoulder Elbow Surg. 2021;30(8):1938-1948. PubMed
  9. Longo UG, Marino M, Lalli A, et al. Arthroscopic management of isolated partial-thickness rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2024;32(9):2358-2375. PubMed
  10. Tsuchiya S, Davison EM, Rashid MS, et al. Determining the rate of full-thickness progression in partial-thickness rotator cuff tears: a systematic review. J Shoulder Elbow Surg. 2021;30(2):449-455. PubMed
    Partial-thickness tears progressed to full-thickness tears at a low rate, about 0.26% per month (roughly 3% per year), over about 3 years of follow-up.
  11. Longo UG, Lalli A, Medina G, et al. Conservative Management of Partial Thickness Rotator Cuff Tears: A Systematic Review. Sports Med Arthrosc Rev. 2023;31(3):80-87. PubMed
    A review found non-surgical care of partial tears, including therapy and injections, gave favorable results.
  12. Ricker E, Stehling L, Klute L, et al. Surgical vs. non-surgical therapy for partial tears of the rotator cuff: a systematic review and meta-analysis of pooled studies with indirect comparison. BMC Musculoskelet Disord. 2026;27(1). PubMed
    A 2026 meta-analysis of 33 studies found slightly higher shoulder scores after surgery than non-surgical care, but the difference was below the threshold patients notice.
  13. Zhu P, Wang Z, Li H, et al. Platelet-Rich Plasma Injection in Non-Operative Treatment of Partial-Thickness Rotator Cuff Tears: A Systematic Review and Meta-Analysis. J Rehabil Med. 2022;54:jrm00312. PubMed
    A meta-analysis of 11 studies found PRP injections improved shoulder function and pain compared with placebo in partial tears.
  14. Desouza C, Shetty V. Effectiveness of platelet-rich plasma in partial-thickness rotator cuff tears: a systematic review. J ISAKOS. 2024;9(4):699-708. PubMed
    A meta-analysis found PRP reduced pain in partial tears, with a more limited effect on function, and results varied widely between studies.
  15. Wang T, Ren Z, Zhang Y, et al. Comparison of Arthroscopic Debridement and Repair in the Treatment of Ellman Grade II Bursal-side Partial-thickness Rotator Cuff Tears: A Prospective Randomized Controlled Trial. Orthop Surg. 2021;13(7):2070-2080. PubMed
    In a randomized trial of grade II bursal-sided partial tears, debridement and repair both gave good results at 18 months, with no difference.
  16. Osti L, Buda M, Andreotti M, et al. Transtendon repair in partial articular supraspinatus tendon tear. Br Med Bull. 2017;123(1):19-34. PubMed
    A review of transtendon repair for partial articular-sided tears found good outcomes across 18 studies.
  17. Familiari F, Gonzalez-Zapata A, Iannò B, et al. Is acromioplasty necessary in the setting of full-thickness rotator cuff tears? A systematic review. J Orthop Traumatol. 2015;16(3):167-74. PubMed
    A review did not support routine acromioplasty during rotator cuff surgery.
  18. Schlegel TF, Abrams JS, Bushnell BD, et al. Radiologic and clinical evaluation of a bioabsorbable collagen implant to treat partial-thickness tears: a prospective multicenter study. J Shoulder Elbow Surg. 2018;27(2):242-251. PubMed
    In a multicenter study of intermediate- to high-grade partial tears treated with the bioinductive collagen implant, tendon thickness increased and clinical scores improved at 1 year.
  19. Hurley ET, Twomey-Kozack J, Doyle TR, et al. Bioinductive Collagen Implant Has Potential to Improve Rotator Cuff Healing: A Systematic Review. Arthroscopy. 2025;41(2):333-342.e2. PubMed
    A 2025 review of 21 studies reported generally good results and low re-tear rates with bioinductive collagen implants, while noting limited high-level evidence.
  20. Camacho Chacón JA, Roda Rojo V, Martin Martinez A, et al. An isolated bioinductive repair vs sutured repair for full-thickness rotator cuff tears: 2-year results of a double blinded, randomized controlled trial. J Shoulder Elbow Surg. 2024;33(9):1894-1904. PubMed
    In a small randomized trial, an isolated bioinductive implant gave better tendon quality and outcomes than a sutured repair for partial tears.
Ready to get it checked? Request an appointment online or call 469-850-0680. Our staff will contact you by phone and text within an hour of your request (during business hours, Monday–Friday, 8 am–5 pm). Walk-in visits are welcome Monday, Wednesday and Friday, 8:30–10:30 am at 6700 Dallas Parkway, Suite 100, Frisco, TX 75034. We see patients from Frisco, Plano, McKinney, Prosper, Little Elm, The Colony, Allen, Dallas and across North Texas. Same-day appointments available.

Request an AppointmentCall 469-850-0680

REGENETEN is a trademark of Smith+Nephew. Dr. Dold is a consultant for Smith+Nephew.

Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed October 2026. This page is general information, not medical advice. Individual results vary.