Rotator Cuff Tears: It’s Not Always Surgery
A rotator cuff tear can sound frightening — particularly when an ultrasound or MRI report describes a high-grade or significant tear.
But there’s an important point to remember:
A scan is only one part of the picture.
Your imaging results can help your physiotherapist and other healthcare professionals understand what is happening in your shoulder, but the words on a scan report don't necessarily determine what treatment you need.
Your symptoms, strength, movement, function, lifestyle, work or sporting demands, goals and response to treatment all matter when deciding on the best approach.
What are the management options for a rotator cuff tear?
There isn't one treatment that is right for everyone. Depending on your individual circumstances, management may include physiotherapy, modifying your activities, an orthopaedic opinion, surgery — or a combination of these approaches.
1. Rehabilitation and physiotherapy
- Progressive rehabilitation can be an important part of managing a rotator cuff tear.
- A physiotherapy program may focus on gradually improving:
- Shoulder strength
- Movement and mobility
- Load tolerance
- Function
- Confidence using your shoulder
- Your ability to return to work, sport and everyday activities
Importantly, rehabilitation isn't necessarily ruled out simply because an imaging report describes a significant tear. Your physiotherapist can help determine what movements and loads are appropriate for you and progressively build your capacity over time.
2. Load modification
Shoulder pain can sometimes flare when you return to activities such as work, gym training or sport. That doesn't necessarily mean you need to stop everything. Instead, modifying the amount, intensity or frequency of activity and gradually rebuilding your tolerance can help you continue moving while allowing your shoulder to adapt.
The goal isn't always complete rest. Often, it's finding an appropriate level of activity and progressing from there.
3. Orthopaedic review
An orthopaedic assessment can provide another perspective and help clarify your treatment options. Importantly, seeing an orthopaedic surgeon doesn't automatically mean you need surgery. A surgical opinion may simply help you understand whether surgery is appropriate for your particular combination of symptoms, weakness, functional limitations, imaging findings and goals.
4. Surgery
For some people, surgery may be an appropriate option. This decision can depend on factors such as your symptoms, degree of weakness, functional limitations, injury circumstances, work or sporting requirements, goals and response to conservative management. And even when surgery is recommended, rehabilitation remains an important part of the process.
Physiotherapy and appropriate load management before and after surgery can help you prepare for and recover from the procedure and work towards restoring function.
So, does a rotator cuff tear mean you need surgery?
Not necessarily.
Two people can have similar findings on an MRI or ultrasound but have very different symptoms, functional abilities and treatment needs. That's why treatment decisions shouldn't be based solely on the scan.
At Back In Motion Aspendale Gardens, our physiotherapists can assess your shoulder, discuss your goals and help develop a management plan based on your individual presentation. That may involve rehabilitation, load modification, referral for further assessment, or a combination of approaches.
What if my shoulder pain gets worse during rehabilitation?
This is an important one. Rehabilitation isn't always a straight line. You may have periods where your shoulder feels better, followed by a flare-up. A temporary increase in pain doesn't automatically mean that rehabilitation has failed or that your shoulder has become significantly worse. Your physiotherapist can help you understand what may have contributed to the flare-up and adjust your rehabilitation and activity levels accordingly.
Progress can take time.
The key message
Your scan is part of the story — not the whole story. The best management approach for a rotator cuff tear is individual. It should consider your symptoms, clinical findings, strength, function, goals, activity demands and response to treatment — rather than simply the words written on an imaging report.
If you've recently been told you have a rotator cuff tear and you're unsure what it means for you, an assessment with a physiotherapist can be a useful place to start. Want to understand your options? Contact Back In Motion Aspendale Gardens to arrange an assessment and discuss your shoulder with our physiotherapy team. Please call us on 95801985 or book online here.