Operative Versus Non-Operative Treatment for Atraumatic Rotator Cuff Tears

Inclusion Criteria: * Aged =\>40 years to \<85 years * Shoulder pain and/or loss of range of active motion, strength or function * MRI-confirmed partial- or full-thickness supraspinatus and/or infraspinatus tear of 4cm or less in longitudinal dimension * Medically fit for surgery, defined as Category I-III per American Society of Anesthesiologists (ASA) Physical Status Classification * Ability and willingness to provide informed consent Exclusion Criteria: * Primary diagnosis is something other than a rotator cuff tear * History (in last 2 years) of shoulder fracture involving the humeral head on affected side * Previous rotator cuff surgery on affected side * Isolated subscapularis \&/or teres minor tear on affected side * Acute rotator cuff tear caused by a severe trauma * Shoulder used as a weight-bearing joint * Contraindication to MRI (claustrophobia, pacemaker, pregnancy, shoulder implant, etc.) * Glenohumeral osteoarthritis on xrays/MRI, as determined by recruiting MD * Grade 4 fatty infiltration of rotator cuff (any tendons) * Candidate for shoulder arthroplasty at baseline * Non-English speaking * Severe problems with maintaining follow-up expected (such as, but not limited to, history of substance abuse, homelessness/incarceration, dementia, brain injury, and psychotic disorders)