Rotator Cuff Tears – Physio Not Surgery?

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Can physiotherapy be an effective alternative to surgery for patients with rotator cuff tears? It is usual when a tear is found in one of the four muscles of the shoulder that make up the rotator cuff (which are subscapularis, infraspinatus, teres minor, and supraspinatus if you wish to improve your anatomical knowledge) that a surgeon will want to stitch the torn muscle back together to repair it.
Tears in the rotator cuff usually mean a painful, weak shoulder. There is no common cause for a tear – it may develop over time or result suddenly from a single traumatic event or injury. If there is a tear in the tendons or muscles of the rotator cuff, you cannot lift or rotate your arms in the same range as previously and there is usually severe pain when the movement is attempted.
There have been three recent studies in 2013 and 2014* that have compared the effectiveness of a physiotherapy programme either instead of surgery or alongside surgical interventions. They looked at patients with varying degrees of non-traumatic rotator cuff tears. The subjects of the study underwent physiotherapy led programmes which combined progressively harder postural, range of movement, and strengthening exercises. This was alongside the use of physiotherapy manual techniques such as massage and joint mobilisations. Overall, the studies’ results showed statistically significant improvements in functional ability, pain levels and a decreased chance of referral for surgery.
For further information on the rotator cuff, click here. If you have any questions, please contact G4 Physiotherapy and Fitness Didsbury, Manchester by emailing admin@g4physio.co.uk or call 0161 4455133.
 
*Kuhn et al (2013) Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. Journal of Shoulder Elbow Surg. Oct;22(10):1371-9. PubMed PMID: 23540577.
Kukkonen et al (2014) Treatment of non-traumatic rotator cuff tears: A randomised controlled trial with one-yr clinical results. Bone Joint J. 2014 Jan;96-B(1):75-81. PubMed PMID: 24395315.
Moosmayer et al (2014) Tendon repair compared with physiotherapy in the treatment of rotator cuff tears: a randomized controlled study in 103 cases with a five-yr follow-up. J Bone Joint Surg Am. 2014 Sep 17;96(18):1504-14. PubMed PMID: 25232074.

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