Treating a rotator cuff tear depends on the severity of the tear, the patient’s age, activity level, and goals. Treatment options range from conservative management to surgical intervention. Here’s an overview:
1. Conservative (Non-Surgical) Treatment:
- Rest and Activity Modification: Avoid activities that worsen shoulder pain, particularly overhead movements.
- Physical Therapy (PT): A key part of non-surgical treatment. PT focuses on improving strength, flexibility, and function in the shoulder. Common goals are to strengthen surrounding muscles to compensate for the tear and improve range of motion.
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen can reduce pain and inflammation.
- Corticosteroid Injections: A steroid injection may be recommended for significant pain relief, especially if there’s inflammation.
- Heat and Ice Therapy: Alternating ice for pain and swelling with heat to improve flexibility and reduce stiffness.
2. Surgical Treatment:
Surgery may be necessary for larger tears, chronic symptoms, or when conservative treatments fail to restore shoulder function, particularly for younger or more active individuals.
- Arthroscopic Repair: Minimally invasive procedure where small incisions are made, and a camera and instruments are used to repair the tear. Common for partial or small tears.
- Open Repair: A larger incision is may be needed for more extensive repairs.
- Tendon Transfer or Shoulder Replacement: In cases of massive tears where tendons cannot be repaired, other tissues or a reverse shoulder replacement may be necessary.
3. Post-Surgery Rehabilitation:
- Immobilization: A sling is worn for several weeks post-surgery to protect the shoulder.
- Physical Therapy: Gradual rehabilitation focusing on regaining motion, strengthening muscles, and restoring full shoulder function. This process can take several months.
- Pain Management: Post-operative pain is managed with medications and ice therapy.
4. Lifestyle Modifications:
- Gradual Return to Activity: Activities such as lifting or overhead movements should be reintroduced slowly to avoid re-injury.
- Strengthening: Continuing shoulder exercises even after formal physical therapy can help maintain long-term shoulder health and reduce the risk of re-tear.
5. Prognosis:
- Many individuals experience full recovery with physical therapy, especially for partial tears. Surgical recovery can take 6-9 months or longer depending on the extent of the tear and the patient’s adherence to rehab protocols.
If you're treating athletes or highly active individuals, emphasizing the importance of proper rehabilitation, shoulder strengthening, and adherence to post-surgical protocols is critical to preventing future injuries.
Author
Dr. Catherine Logan, MD, MBA
Catherine Logan, MD, MBA, MSPT, is a sports medicine orthopaedic surgeon specializing in complex knee and shoulder surgery at Colorado Sports Medicine and Orthopaedics (COSMO) in Denver, Colorado. As a former physical therapist & trainer, Dr. Logan provides a distinct expertise in sports injury, prevention, and surgical management.
