My younger brother had an MRI of his shoulder to figure out what was wrong with his arm. They found a torn rotator cuff. But the surgeon said it was inoperable. Why can’t they fix it?

The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint. They work together to move the arm and hold the shoulder in place. Tears of the rotator cuff are common in athletes, manual laborers, and older adults.

Trauma and overuse can lead to rotator cuff tears in younger adults. Degenerative changes linked with aging are a more common cause among older adults. The tear is usually classified as partial-thickness or full-thickness. A full-thickness rotator cuff tear is the same as a ruptured tendon.

Sometimes damage to the tendon is massive and is considered inoperable. This usually means there’s not enough tendon left to reattach. In other cases, the tendon retracts so far into the belly of the muscle, it can’t be retrieved and reattached.

The patient can often regain stability use of the arm. This is done by strengthening the other muscles around the shoulder. A physical therapist evaluates the patient and sets up an appropriate exercise program. If there is a loss of motion, range of motion exercises are included. The patient’s age, occupation, and activity level are all considered when establishing a rehab program.