Physical Therapy Versus Surgery for Rotator Cuff Tears

Shoulder pain is one of the most common orthopedic issues, and it becomes increasingly common with age. Within the shoulder is a group of tendons and muscles that keep the joint stabilized and give the upper arm its range of motion. This is called the rotator cuff, and it can develop partial or full tears that cause pain and limit range of motion.

Rotator cuff tears may be treated either conservatively or with surgery. Initially, doctors usually recommend conservative treatment, such as physical therapy. Rotator cuff tears from a traumatic incident are almost always treated with surgery.

How Physical Therapy Helps Improve Symptoms of Rotator Cuff Injury

Patients with rotator cuff tears that are a result of overuse and wear-and-tear usually respond well to a focused physical therapy program. The aim of physical therapy is not to treat the tear, but to improve shoulder strength and function, as symptoms can improve even with a partial or complete tear. A physical therapist (PT) will evaluate the problem using special tests to determine how to help relieve symptoms and gradually get back your shoulder function.

Physical therapists design exercise programs that will help slowly build strength, improve range of motion, and restore function to the shoulder. To help manage symptoms, the PT may use modalities such as heat and ice therapy, ultrasound, and electrical stimulation. It is not a good idea to stop using the affected arm and shoulder for a long period. Keeping moving and exercising proves to be better for this type of injury.

On whether physical therapy is better than surgery at treating rotator cuff tears, the evidence is much more limited. In a limited study of 46 patients who underwent physical therapy treatment, almost sixty percent experienced an improvement in symptoms, while 30 percent experienced a worsening of symptoms. The remaining 11 percent experienced neither.

There have been some cases where patients with a failed rotator cuff repair still express satisfaction with the results of surgery, and it may have something to do with the structured physical therapy rehabilitation program they underwent following surgery.

Surgery for Rotator Cuff Tear

Patients with continuing and severe pain or those who have torn their rotator cuff due to a traumatic incident may be recommended surgery. A partial rotator cuff tear may be treated with a procedure called debridement, where the doctor trims the frayed edges of the torn rotator cuff. Repairing a full rotator cuff tear usually involves the removal of bone spurs along with reconstruction or a tendon transfer. Doctors may use the open (involves the removal of the deltoid muscle), mini-open (no need to detach the deltoid muscle), or arthroscopic (using a long, thin, instrument with a camera or arthroscope) technique to perform surgery.

Factors such as the cause and severity of the injury, the age of the patient, and the lifestyle of the patient are important considerations for the type of treatment a doctor recommends.

Rotator Cuff Treatment in Central Maryland

At Orthopaedic Associates of Central Maryland, our healthcare team uses physical therapy and surgery to treat patients with rotator cuff injuries. Our two orthopedic surgeons, Dr. Brian Janz and Dr. Khurram Pervaiz are both recognized in the field for their expertise in upper extremity surgery. Our goal is to give you the best outcomes from treatment. To schedule an appointment with Dr. Janz or Dr. Pervaiz, call us at (410) 644-1880 or use our online request form.