Physical Therapy vs. Surgery for Torn Rotator Cuffs
If you have a rotator cuff tear, physical therapy may be just as effective of a treatment option as surgery, according to research. Rotator cuff tears are a frequent cause of shoulder discomfort and functional disability in the upper extremities.
A physical therapist can help improve your shoulder pain by teaching you exercises to regain the normal range of motion, strength, and function. To find out what's causing your pain, your physical therapist will most likely conduct an initial examination and carry out particular tests on your shoulder to identify the source of your discomfort.
There are a variety of reasons for shoulder discomfort. These can include:
- Arthritis
- Labrum tear
- Tendonitis
- Bursitis
- Rotator cuff tear
If your shoulder discomfort persists, you may need to see your healthcare practitioner for a diagnosis. An MRI is a relatively common procedure that allows doctors to take a look at the soft tissue structures in your shoulder. This MRI image can show rotator cuff tears. These muscle and tendon tears may be causing your shoulder pain and dysfunction.
If your healthcare provider suspects a rotator cuff tear is causing your shoulder pain, he or she may suggest various treatments. Some patients with a rotator cuff tear opt for conservative treatments, such as physical therapy. Others require a surgical procedure called a rotator cuff repair.
The question then becomes, if you have a rotator cuff tear, is surgery or physical therapy the better option?
What the Research Shows
Researchers investigated 173 people aged 55 and older who had rotator cuff injuries without being hit. We assigned each research participant to a group of physical therapists who specialize in shoulders, or to a group that would have surgery plus PT. Physical therapy, along with other conservative techniques, proved to be effective in treating rotator cuff tears in a significant number of individuals. There was no significant difference between groups 12 months after the intervention. They found that "conservative treatment," meaning a less-invasive option, should be the go-to method to treat this condition."
One important caveat to consider about the study is that it only included patients with a specific type of rotator cuff tear in the supraspinatus muscle. This is one of four rotator cuff muscles, so keep that in mind when evaluating the findings. So, if you have a tear in a different muscle, does that mean you shouldn't try physical therapy? Absolutely not! The study's results may not be relevant to your situation. A shoulder surgeon will evaluate the functionality of your shoulder and decide whether surgical therapy is required to restore it. Before opting for surgery, you might want to try physical therapy for your shoulder.
What does this all imply for you? To begin with, if you have shoulder discomfort as a result of a rotator cuff tear, you should seek physical therapy.
What Is the Rotator Cuff?
There are four muscles in the rotator cuff group, which arise from your shoulder blade and wrap around your upper arm. The muscles in your arm contract whenever you lift it to help keep the arm stabilized in its shoulder socket. Your rotator cuff muscles act as stabilizers for your shoulder, allowing you to move it more freely.
What Happens When Your Rotator Cuff Is Torn
If you experience a rotator cuff tear, muscles that are responsible for support in your shoulder may not function properly, resulting in symptoms like:
- Shoulder pain
- Loss of ROM
- Decreased strength and mobility around your shoulder
- Decreased stability when lifting your arm overhead.
Not everyone who has a rotator cuff tear experiences discomfort or loss of function and strength, though. A rotator cuff tear is not the only cause of shoulder pain. Not everyone who has shoulder discomfort has a rotator cuff tear. In other words, simply because you have a rotator cuff tear does not mean you definitely need surgery. If you have rotator cuff pain and wonder if your physical therapist can help, it's worth looking at how your shoulder is functioning and moving.
Physical Therapy for Rotator Cuff Tears
A physical therapist will have you do active exercises to help improve your shoulder's movement and function if you visit them for treatment of a rotator cuff tear.
Exercises may include:
In addition, to talk therapy, your therapist may also use different treatments and methods to help reduce your pain and improve the function of your rotator cuff.
These may include:
- Heat or ice
- Ultrasound
- Electrical stimulation called NMES
- TENS
- Kinesiology taping
- Shoulder Pulley
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It's worth noting that although passive therapies are sometimes ineffective for rotator cuff tears, they may be beneficial. Yes, they may make you feel wonderful, but research has shown that exercise is the best course of treatment for a rotator cuff injury.
Final Word
Working out in physical therapy is critical; your shoulder will not heal overnight. If you consistently apply yourself to keep your shoulder mobile and strengthen your rotator cuff, you may recover from a rotator cuff tear and resume your regular routine.
If you have a rotator cuff tear and are seeking treatment, visit a shoulder specialist to discuss your options and develop a plan that works best for you.
