Have you been suspected of having a rotator cuff tear? What does this mean, and does it matter?

What is the rotator cuff?

The rotator cuff is a group of muscles with three main roles:

• Controlling the shoulder joint during movements
• Force production, primarily into rotation
• Initiation of shoulder movement

Is imaging useful?

• Would you believe that if we took scans of people with shoulder pain and people without shoulder pain and gave them to a radiologist, they would not be able to tell you who has pain?
• The older we get the more likely we are to find ‘abnormal’ pathology. These reflect age-related changes, no more different than finding grey hairs on your head! 
• There was also found to be no correlation between pain levels and cuff tear severity on imaging

So how do I know when to get imaging?

• The physiotherapist will help guide you on when it is appropriate to get imaging. 
• Usually this includes situations where there are worrying histories inconsistent with a rotator cuff tear or where there is a clear traumatic mechanism followed by immediate pain and loss of function with no improvement for weeks after your injury.

Surgery or physiotherapy?

• Physiotherapy works to restore normal movement patterns and strength around the shoulder to address your pain. This has been shown to be successful in 75-80% of cases.
• There are comparable outcomes between physiotherapy and surgery, but physiotherapy has been shown to be less costly and less risky overall
• There are other considerations which must be made when deciding whether to undergo surgery such as your age, general health, duration of symptoms or functional demands
• Discuss this in collaboration with your physiotherapist to determine which the best route is for you

Is it one or the other?

• Want to see how you go with physiotherapy first? Well, good news. Studies show that delaying surgery doesn’t impact outcomes at all
• In fact, patients have better outcomes with physiotherapy prior to surgery

As you can see, rotator cuff tears are challenging conditions to navigate. Come see the team at Bassendean Physio to see how we can help you.

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