But patients don't have to choose between nagging pain and surgery with big scars.
[Ads /]
A Temple Health surgeon repairs most of them with minimally-invasive, arthroscopic surgery.
One of her patients shared the experience.
Sandy Magee-Evans of Elkins Park, Pa., has spent her life in nursing - first in ICUs and cancer units, and now in teaching.
"She's a natural leader, a natural teacher," says orthopaedic surgeon Dr. Leslie Barnes.
Sandy tried to ignore pain & weakness in her right shoulder until one night at dinner.
"I went to pass a dish with potato, with mashed potatoes, in it. And my arm went down a little," she says, recalling that surprising moment.
Dr. Barnes, a Temple Health shoulder and elbow specialist, says those are common symptoms.
"They have pain with overhead activity," she said. "The second thing they start to feel is actually weakness, so they feel a loss of strength or power in the shoulder."
[Ads /]
The first doctor Sandy consulted said nothing could be done, but Dr. Barnes said she could repair the rotator cuff tear with arthroscopic surgery.
The rotator cuff is a group of muscles and tendons which keeps the upper arm bone in the shoulder socket and helps us raise and move our arms.
Most strains can heal without surgery.
"But when there's a tear, that means the tendon is detached from the arm," says Dr. Barnes.
So it must be surgically re-attached.
However, the doctor says that doesn't usually doesn't mean big incisions.
"The vast majority of the time, arthroscopic surgery is the way to go," she says.
[Ads /]
"We have the camera and the dedicated instrumentation where we can work through a very small skin opening to actually accomplish a lot of work," she continues.
While that doesn't shorten the 10-12 week healing inside, it means faster recovery on the outside.
"I don't have any cuts or anything on my shoulder," she says happily.
And even before the surgery last fall, she got help coping from Dr. Barnes' team, especially from the practice manager.
"She gave me some wonderful tips on what to do with one arm, and things to do ahead of time to practice, like how to brush your teeth with your left arm," she says with a smile.
Sandy is back teaching this semester, even as she wraps up physical therapy, free of pain or weakness.