Questions and Answers
Q: What rehabilitative techniques
are necessary for torn rotator cuffs? When is surgery
necessary and when is it avoidable?
Typically, in degenerative rotator cuff tears, shoulder
range of motion is abnormal and muscles are weak.
A muscle strength imbalance often exists. Additionally,
there are postural concerns that need to be addressed.
Therefore, normalization of range of motion and strength
are necessary as well as improvement of posture. Above-the-head
and heavy lifting activities are to be avoided.
Treating rotator cuff injuries is not simplistic.
There are chapters in books and whole books themselves
written on rotator cuff injuries for both post surgical
and nonsurgical rehabilitation techniques. Based on
my experience of 15 years and my supervision of probably
2000-3000 rotator cuff injuries, success in non-surgical
rehabilitation is 60-80%. Of course, age, severity
of rotator cuff tear, current physical status, etc.
are all factors that affect overall outcomes. Typically,
patients choose surgery based primarily on pain. Secondarily,
surgery is chosen due to loss of function. Elderly
patients more often choose not to pursue surgery as
compared to younger, athletic populations. I certainly
recommend conversing with your orthopedic doctor about
surgical and nonsurgical alternatives.
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