You don't always need surgery

In a previous blog post we dove deep into possible causes of rotator cuff tears but what if you're confronted with a rotator cuff tear diagnosis from

HEALTH & FITNESS MUSINGS

In a previous blog post we dove deep into possible causes of rotator cuff tears in sedentary adults and what we could do to minimize the risk of having these issues in the first place. But what if you're confronted with a rotator cuff tear diagnosis from your doctor? While you are weighing your options, please consider the results of a recent study comparing three different methods (surgery, arthroscopic surgery, and physiotherapy) of treating non-traumatic tears of the supraspinatus tendon in patients above 55 years of age. The study authors found that surgical treatment is no better than conservative treatment (physiotherapy). This suggests conservative treatment should be your first step. I know you're in pain, but it can't hurt, right? 
A few facts from the study to put this in perspective:

  • the rate of tears of the supraspinatus tendon in the non-athlete population aged 60-80 years is between 20 and 30%
  • at least 250,000 rotator cuff repairs are performed each year in the United States, with estimated direct costs of $3 billion
  • reports point to tendon degeneration as a main cause of these tears
  • degenerated torn tendons may not heal at all, even with surgical repair
  • the rate of post-operative re-tears is high

With these facts in mind, researchers at Turku University Hospital in Finland set out to compare treatment methods. People with rotator cuff tears (mean age = 55) were put into 3 groups: 

  1. physiotherapy only
  2. acromioplasty (arthroscopic surgery - using a tiny camera to examine and repair the tendon) and physiotherapy
  3. surgical rotator cuff repair, acromioplasty and physiotherapy

Results after one year follow-up: surgical repair of a supraspinatus tear did not improve the outcome as compared to the other methods.
All studies have their drawbacks and limitations. I am writing about this one since it adds to existing literature (see study references 15, 21-23) demonstrating successful conservative treatment of rotator cuff tears. Why not try it first? Do you have shoulder pain or a diagnosed rotator cuff tear? Be sure to first discuss all your options with your doctor and health care team. Reach out to me with any questions or comments.

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