Rotator cuff tears are an extremely common injury issue with prevalence increasing with each decade of life. You probably know how common they are, and might even know people with this injury, or have even had one yourself. What you probably don’t know is that most of them are actually asymptomatic.
A research study done by Hirashima et al in 2013 looked at 664 participants with varying ages starting at 20 up to 90. Their research showed that 22% of these participants had full thickness rotator cuff tears but only 34% of those were symptomatic, meaning they actively had shoulder pain and limitations. Their study also showed the incidence of this increasing with each decade of life. These findings are consistent with most studies on this topic.
What is the rotator cuff though?
Rotator cuff tears, occur in he rotator cuff. This area of the shoulder is comprised of 4 muscles that surround the shoulder joint and help control positioning of the shoulder and allow for your arm to move in all the ways it does. The shoulder joint itself is a ball and socket joint, but think of the socket part like a plate and the ball like a golf ball. Those 2 things don’t make for a very congruent surface, so the rotator cuff muscles along with several other structures create that dynamic stability for the ball and socket.
The 4 rotator cuff muscles are the supraspinatus, subscpaularis, infraspinatus, and teres minor. The supraspinatous being the most frequently injured of the muscle group.
Physical Therapy to Manage Rotator Cuff Tears
With small rotator cuff tears, physical therapy is a great choice for management. The chances of healing on its own/or just stabilizing (not getting worse) are higher. The chances of the tear progressing are lower than with more significant tearing. In most cases, pain can be resolved and you can fully return to previous level of function and activity. Physical Therapy in these cases will strength up all the muscles around the shoulder and improved scapular control and positioning.
With moderate to massive tears, the primary concern is progression of tear, which is more likely with bigger tears. They can still be managed well in the short term, but the long term chances of progression of the tear are much higher. Most research supports a trial of conservative care (physical therapy) is still the best line of defense.
When is Surgery the Proper Treatment
Surgical treatment of the shoulder shoulder be considered after at least 2 months trial of conservative care with physical therapy. Degenerative full thickness tears tend to respond better to surgical treatment in the long term but can be managed well with conservative care until the decision for surgery is made.
Learn More: https://loudounsportstherapy.com/rtc-rehab-surgery-tears/
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