Rotator cuff tears in my opinion ……

It is likely that if you ask around in your circle of friends, family and colleagues someone you know is likely to have been affected by a rotator cuff tear. Now this doesn’t always results in symptoms however it can at times. In fact rotator cuff tears can even be considered a normal sign of ageing!! A study that screened 644 shoulders under ultrasound found 147 had cuff tears and of these 147 only 35% had pain¹.

The shoulder joint is made up of the humerus and the scapula. The joint itself is controlled and stabilised by 7 muscles, 4 of the deepest are called the rotator cuff muscles. These include supraspinatus, infraspinatus, subscapularis and teres minor.

When one or more of these muscles are torn you very commonly see that surgery is the end treatment option. According to an American Study there are 75 000 – 250 000 rotator cuff surgery’s each year in the US where the failure rate is between 25%-90%.

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In 2013 Kuhn et al. performed a prospective cohort study over 2 years with 452 patients who had non traumatic full thickness tears. They found that physiotherapy was effective for treating non traumatic full thickness rotator cuff tears in approximately 75% of patients that were followed up over a 2 year period².

If you were wondering what the physiotherapy involved, it included:

  • Daily range of motion exercises
  • active training of the scapular muscles
  • Daily flexibility of the anterior and posterior shoulder
  • strengthening exercises 3 x week
  • Manual therapy to augment the exercise

As you can see most of it involved moving and strengthening with manual therapy as an adjunct as well as this most of strength work was done independently. What Kuhn et al. found was that patients had increase in their range of motion and improvements in patient reported measure outcomes.

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Now it is important to note that there is still 35% that did require surgery and it is also important to remember the realistic outcome that some rotator cuff muscles just don’t rehab that well.

Need some advice on shoulder strengthening or suffering from a rotator cuff tear? Click here to book a session.

References:

  1. Kuhn,J. 2009 Exercise in the treatment of rotator cuff impingement: A systematic review and a synthesized evidence-based rehabilitation protocol.18, 138-160. doi:10.1016/j.jse.2008.06.004
  2. Kuhn, J. E. et al. (2013). Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. Journal of Shoulder and Elbow Surgery, 22(10), 1371–1379. doi:10.1016/j.jse.2013.01.026
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