Inclusion Criteria:  pain at rest or exercise laterally on the shoulder, a painful motion arc, a positive impingement sign, passive shoulder motion of at least 140° for abduction and flexion, demonstration of a full-thickness tear of the rotator cuff by both sonography and magnetic resonance imaging (MRI), a tear size not exceeding 3 cm, muscle atrophy not exceeding Thomazeau stage 2 on MRI.  Exclusion Criteria:  patient age of <18 years and older than 65 years, tears involving >25% of the width of the subscapularis tendon, presence of other local or systemic diseases affecting shoulder function, history of surgical treatment of the involved shoulder, medical contraindication for training, inability to understand written and spoken communication.