Rotator cuff tears are painful and limiting for patients; larger tears have had poor outcomes in general and have often been deemed irreparable. But a new procedure using a subacromial balloon spacer offers hope to patients with large tears, a way of relieving their pain and restoring range of motion—and without the tissue grafts of capsular reconstruction. Amit Momaya, MD; Aaron Casp, MD; and Eugene W. Brabston, III, MD, of the UAB Medicine Sports Medicine program, have led research and early implementation of this procedure. They discuss the function of a biocompatible, saline-filled balloon in keeping the humeral head centered during shoulder movements, explore possible explanations for why this procedure is so effective, and explain its advantages for recovery. Find out which of your patients may now have an option for restoring shoulder mobility.