Rotator Cuff Tears - Do I need Surgery?

Figure 1: Shoulder Pain - Rotator Cuff Tears - Physio Frenchs Forest, Physio Macquarie Park

What is the rotator cuff?

The shoulder is made up of the bone in your arm (humerus), your shoulder blade (scapula) and the collar bone (clavicle). The upper arm bone fits into a socket in the shoulder blade forming the gleno-humeral joint. The shoulder socket is supported by the rotator cuff. The rotator cuff consists of the subscapularis, supraspinatus, teres minor and infraspinatus. The muscles work collectively to move the should into shoulder flexion, abduction, external rotation, internal rotation, and extension.

                                      

What are the type of rotator cuff tears?

One reason you may have pain in the shoulder is due to either a partial or full thickness tear of the rotator cuff. A tear can be occur either with:

  • Acute traumatic tear by lifting an object that is too heavy or having the shoulder

    pulled quickly.

  • Acute traumatic tear from landing onto the shoulder with a large force

  • Degenerative tear due to repetitive stress on the muscle/tendon. For example

    occupations that require lifting the arm overhead repetitively.

 

What are the signs and symptoms of a rotator cuff tear?

-       Avoiding certain activities because they cause pain such as lifting your arm

above your head or reaching into the back seat of the car

-       Loss of shoulder range of motion

-       Difficulty sleeping on the affected shoulder

-       Pain or tenderness when reaching overhead

-       Pain in the shoulder, especially at night

-       Progressive weakness of the shoulder

-       Trouble reaching behind the back

 

How common are rotator cuff tears?

Tears of the rotator cuff are common. The prevalence of a rotator cuff tear is 25% in those over 50 and 20% in those over 20 years of age. However only 1/3 of these tears are in pain (1).

 

Figure 2: Shoulder Pain - Rotator Cuff Tears - Physio Frenchs Forest, Physio Macquarie Park

Non-operative management for rotator cuff tears/Physiotherapy for rotator cuff tears?

Conservative management involves the use of non-steroidal anti-inflammatory medication and exercise to achieve full pain free range of motion. Conservative management has shown to be effective in 73-80% of patients with full-thickness rotator cuff tears (2).

 

Surgical Management of rotator cuff tears?

The American Academy of Orthopaedic Surgeons (AAOS) indicates surgery should be performed on those with the following:

- Symptoms >6 months

- Rotator cuff tears >3cms

- Significant weakness and loss of function

 

See our expert Physiotherapy team at Frenchs Forest and Macquarie Park!

References:

1)    Itoi, E. (2013). Rotator cuff tear: Physical examination and conservative treatment. Journal of Orthopaedic Science, 18(2), 197-204. doi:10.1007/s00776-012-0345-2

2)    Lambers, H., Frederik O., Van, R., Koorevaar, R., Van E, Pepijn J., Westerbeek, R., Van‘t R. (2015). Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: A randomized controlled trial. Journal of Shoulder and Elbow Surgery, 24(8), 1274-1281. doi:10.1016/j.jse.2015.05.040

Reece Jonesrotator cuff tear, rotator cuff rehab, physio for shoulder pain, shoulder pain, shoulder bursitis