Shoulder injuries from rotator cuff tears are something we commonly see in the clinic. Whether it’s from playing a sport, an overuse injury from work or daily life, or just lifting something too heavy, rotator cuff injuries can happen for a wide variety of reasons.
Unfortunately, there is a lot of fear around shoulder injuries, especially after getting an ultrasound done and seeing words like “tear,” “degeneration,” and “tendinosis.” Understandably, the question then becomes, will I need surgery? Thankfully, surgery is only reserved for very specific and severe cases of shoulder injury. In the vast majority of cases, conservative management with Physiotherapy is the gold standard of treatment.
What is a rotator cuff injury?
The rotator cuff is made of 4 muscles and their tendons around the shoulder joint. Sometimes, they are called the SITS muscles, an acronym for supraspinatus, infraspinatus, teres minor, and subscapularis. Each muscle has a slightly different function, but altogether their job is to hold the arm bone inside the shoulder socket while the arm moves.
A rotator cuff injury usually falls into 2 issues.
- Tendinopathy: A general term to describe a pathology and degeneration with the tendon.
- Tears: The tear can be partial thickness (incomplete) or full thickness (complete). Partial means part of the tendon is still intact, full means the tendon has been completely severed and is a more serious condition.
These 2 conditions are also not mutually exclusive. Long term tendinopathy leads to a higher chance of a tear happening, as the tendon health becomes compromised. Similarly, a tear that does not undergo proper rehab may not heal to 100% and lead to tendinopathy.
What are the symptoms of a rotator cuff injury?
Generally, you may have a rotator cuff injury if you have:
- Pain when reaching overhead
- Difficulty sleeping on your side
- Pain is worse at night
- Difficulty putting clothes on, especially a bra or a jacket
- Difficulty lifting or carrying
- Clicking or popping in the shoulder
How long does a rotator cuff injury take to heal?
Generally, anywhere from 6-12 weeks of rehab is needed, depending on the nature if the injury. More severe or chronic conditions may land closer to the 12 weeks time period, while smaller acute tears may recover in 6 weeks. Your shoulder will likely pass through several stages of rehab. Keep in mind these may overlap.
- Pain control and restoring range of motion
- Strengthening and scapular mechanics
- Strengthening and weight training
- Sport-specific training
Surgery or physiotherapy, how do I know?
Research has shown that for partial tears and chronic tendon degeneration, conservative care with physical therapy is the first choice. With the help of a Physiotherapist, many patients can return to their daily activities and sports. Treatments may include targeted strengthening exercises, mobility exercises, manual therapy, and more!
Surgery may be indicated in a highly traumatic injury causing complete or large tears to multiple tendons. Additionally, a huge loss in function and range of motion ofthe shoulder suggests a higher severity. Finally, in cases where physiotherapy has been tried for several months with no real improvements, surgery may be indicated.
Either way, physiotherapy will play an important role whether a surgery is happening or not. It is a necessary part of the rehab, pre-surgical, and post-op protocol if needed. Surgery is always the last resort due to the risks involved. If your shoulder can heal without it, you should take that chance!
Looking for help with shoulder pain?
Look for PhysioNow! We have expert physiotherapists knowledgeable in rotator cuff pain ready to assist you. Whether you are worried about surgery, prepping for one, or trying to avoid one, we can help! We have 10 locations across the West GTA including Burlington, Oakville, Mississauga, and Etobicoke. Don’t let your shoulder pain keep you from your daily life or sports. Book with PhysioNow today for your first assessment and treatment!
