Rotator Cuff Tear: Can Physical Therapy Help Avoid Surgery?

The "rotator cuff" is the group of 4 muscles and their tendons responsible for keeping the shoulder joint stable. Injuries to the rotator cuff are common—either from accident or trauma, or with repeated overuse of the shoulder. Risk of injury can vary, but generally increases as a person ages. Rotator cuff tears are more common later in life, but also can occur in younger people. When left untreated, a rotator cuff tear can cause severe pain and a decrease in the ability to use the arm.

A recent study in the Journal of Shoulder and Elbow Surgery looked at whether or not physical therapy can help avoid surgery on a rotator cuff tear. The MOON Shoulder Group, which is a multi-center network of research teams around the country, followed a group of 381 patients with atraumatic full-thickness tears of the rotator cuff for a minimum of two tears. The patients performed 6-12 weeks of nonoperative physical therapy focusing on basic rotator cuff strengthening, soft tissue mobilization, and joint mobilizations. At the six-week mark, patients were assessed and 9% chose to have rotator cuff repair surgery at that point. At 12-weeks, an additional 6% chose to have surgery, and, in total, 26% of patients decided to have surgery by the 2-year follow-up mark. That means nearly 75% of patients avoided rotator cuff repair surgery by performing physical therapy despite having full thickness cuff tears. 

Physical Therapy can help you reduce the worsening of the symptoms of a rotator cuff tear and even decrease your risk of worsening a tear, especially if you seek assistance at the first sign of shoulder pain or discomfort. To avoid developing a rotator cuff tear from an existing shoulder problem, it is imperative to stop performing actions that could make it worse. Your physical therapist will help you strengthen your rotator cuff muscles, train you to avoid potentially harmful positions, and determine when it is appropriate for you to return to your normal activities.

To maintain shoulder health and prevent rotator cuff tears, we recommend that you:

• Avoid repeated overhead arm positions that may cause shoulder pain. If your job requires such movements, seek out the advice of a physical therapist to learn arm positions that may be used with less risk.
• Apply rotator-cuff muscle and shoulder-blade strengthening exercises into your normal exercise routine. The strength of the rotator cuff is just as important as the strength of any other muscle group. To avoid potential harm to the rotator cuff, general strengthening and fitness programs may improve shoulder health.
• Practice good posture. A forward position of the head and shoulders has been shown to alter shoulder-blade position and create shoulder impingement syndrome.
• Avoid sleeping on your side with your arm stretched overhead, or lying on your shoulder. These positions can begin the process that causes rotator cuff damage and may be associated with increasing your pain level.
• Avoid smoking; it can decrease the blood flow to your rotator cuff.
• Consult a physical therapist at the first sign of symptoms.

Our physical therapists will work with you to restore your range of motion, muscle strength, and coordination, so that you can return to your regular activities. In some cases, you may learn to modify your physical activity so that you put less stress on your shoulder.  If you do decide to have surgery, your physical therapist can help you both before and after the procedure. Regardless of which treatment you have—physical therapy only, or surgery and physical therapy—early treatment can help you speed the healing process and avoid permanent damage.

If you are suffering from the symptoms due to a rotator cuff tear, call us today. We can get you the help and relief you need and get you back to doing the things you love without experiencing pain!

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