Rotator cuff tears are considered a common finding with advancing age. Just as we get grey hairs or wrinkles, we expect age-related changes to occur internally too, and not all of them will cause pain.
Generally small to medium rotator cuff tears will be asymptomatic but large tears are more commonly associated with shoulder pain and decreased function.
We see it all too often in the clinic, that people who experience shoulder pain will have consulted their GP, been referred for imaging and a corticosteroid injection (or even about to have their second injection) and considering surgical intervention before they even reach a physiotherapist for opinion and conservative management.
A systematic review demonstrated the effectiveness of surgery vs exercise-based rehabilitation on quality of life, disability, and pain for individuals with large rotator cuff tears. Outcomes were as follows:
- Pain: No significant difference between surgery and exercise-intervention groups at 6 months
- Function: No significant difference between surgery and exercise-intervention groups up to 12 months
- Quality of life: No significant difference between surgery and exercise-intervention groups up to 12 months.
What does all this mean for you? If you’ve received your Ultrasound or MRI results showing a large rotator cuff tear, you have two evidence-based options with similar effectiveness – exercise and surgery. Given the costs and risks associated with surgery compared to exercise with no real added benefit, the rational conclusion would be to trial exercise rehabilitation first and if there is no sufficient improvement (to meet expectations or your goals) then surgery makes a viable secondary option.
Source: PROHEALTH PHYSIO & FITNESS
Title: Rotator cuff tear – What’s next
Read time: 7 mins