The shoulder can move in all sorts of ways. Unfortunately, this sets the shoulder up for tears and injuries. Did you know, roughly one in four people age 60+ have tears in their rotator cuffs?1 People of all ages can tear the rotator cuff, but most tears are non-painful. However, some tears can be debilitating.
The rotator cuff is a collection of tendons and muscles fused to a capsule. As a group, this structure provides stability to the shoulder throughout its range of motion.
A tear can be diagnosed with diagnostic ultrasound imaging.2 A tell-tale sign is shoulder pain that’s worse at night. The pain during the day is often more tolerable, but it can be aggravated by specific activities.
Research suggests that some people can recover with physical therapy alone, but not all. Tears that develop without a sudden, major trauma do well in physical therapy. These are likely degenerative tears. In one study, 84% of patients who received physical therapy alone did not need surgery for more than four years.3 Most tears of less than 50% thickness also were treatable with rehab alone. In that same study, only 16% of people with traumatic tears were able to avoid surgery, and a minority of patients with greater than 50% thickness tears succeeded with rehab alone.
Some patients need surgery followed by physical therapy and may benefit from pre-surgical physical therapy as well. A study recently published in the American Journal of Sports Medicine finds that delaying surgery for a course of conservative treatment in partial thickness tears improves functional results of surgery.4