What To Do With A Rotator Cuff Tear.
Let’s assume you’ve had some shoulder pain that won’t seem to go away.
It’s a pain that might be in the front or back of your shoulder and possibly radiates down the side of your arm towards the middle of your upper limb. Overhead activities such as lifting or reaching may aggravate it.
You might feel pain and discomfort when you try to sleep on that particular side. By now you may notice weakness of your arm and difficulty with routine daily activities such as combing your hair or reaching behind your back.
It’s possible you felt the cause of the injury during an acute episode, where you went to do something and felt it immediately.
But more likely it’s something that’s happened and you can’t quite put your finger on what may have caused it.
So you report to your GP and/or Physio and through a series of clinical tests and maybe even an ultrasound or MRI they see something they think is a rotator cuff tear..
So you’ve been told you have something called a rotator cuff tear – now what?
What the hell does that mean and what is going on?
What is a Rotator Cuff tear?
Well, here’s a visual:
Now you might be saying to yourself, “ok so how bad is it?”
Well, you’ve heard the saying “oils ain’t oils”, well tears ain’t tears.
There are different types of tears or strains which you can read about here
Do I need surgery to fix a rotator cuff tear?
The biggest fear or question I come across with my clients in the clinic is that they will need to undergo surgery to fix this problem – so is that the case for you?
Most of the time – No. Hurray!
For most cases there is a whole mountain of evidence to support the use of physiotherapy over surgery as you can see for yourself here
However, in order to give a more thorough answer there are some nuances to be addressed.
When might you need surgery?
There are a few instances where it’s worth considering:
- You have a grade 3 tear (refer to the article above) – these won’t heal on their own, but you can still get your function back with Physiotherapy. The determining factor with these is often your age and activity level ie: younger and more active = more of a surgical candidate than an older and less active client.
- You have a grade 2 tear but are an extremely active person or professional athlete and your job requires a lot of manual work – In this case surgery may be seen as a pre-emptive move to restore the tendon before you return to high level activity.
For a detailed discussion on this topic refer to this article below and be sure to watch the video discussion.
One of the most common questions people with this injury ask us in the clinic is ” Will I do further damage if I continue to use it?”
This is where things can get a little tricky so listen up..
Consistent, aggravating activity can sometimes increase the magnitude of a tendon tear.
However, a tendon injury will NOT heal without a graded exposure to load forces to stimulate the remodeling of the cells which make up your tendon fibres. This involves a stair-stepped strengthening program which occurs over a period of at least 6 weeks, as that’s the minimal amount of time required to establish a decent amount of healing and reconditioning of your tendons.
So what are you supposed to do and at what stage and how much?
This is why you need a good physio to be able to outline a game plan to answer the above questions.
In our clinic we generally breakdown the healing and recovering into 3 stages:
- The acute: this is where we settle your pain and use more manual therapy techniques as well as educate you on what needs to happen at which stage of your recovery journey.
- The rebuilding: during this stage we work on a combination of strengthening exercises which progress as you heal, as well as facilitate your progress with pain relief techniques. This is where you start to see huge gains.
- The maintenance stage: this is the often-neglected follow up process where we check in roughly 6 weeks after you’re feeling 100% to re-test you and assess your risk of re-injury.
In my experience, tendon injuries, particularly rotator cuff injuries are often underrated by the client. They think it should get better quickly – and the pain often does. But what’s so crucial to understand is that in cases like these, just because your pain is getting better, doesn’t mean you’ve fully healed. Which is why if your physio assesses you and says you need 6 weeks of therapy – for god’s sake it means 6 weeks – not 2-3!!
Everything we do in our clinic has a scientific reasoning for it – rotator cuff issues and shoulder pain are some of our most common presentations we deal with and we’ve got it down to a fine art.
So if you’ve suffered a rotator cuff tear – our Elwood physio can help!
If you’ve strained or torn your rotator cuff, the first thing you should do is call and book a session with your local physiotherapist!
Seriously, it’s so much easier if you just get onto it and do it right the first time.
At Physio AUS, we’re experts at helping people like you recover from musculoskeletal issues, including strains and sprains.
Using our unique AUS system, we’ll get to the heart of the issue.
This allows us to prescribe unique solutions. In addition to tailored routines and stretches, we’ll also look at whether physical manipulation will help, as well as technique.
Many of our cases are athletes or labourers who’ve come to us for muscle or joint pain. Our experienced physios will analyse your technique and determine if that is a contributing factor. If it is, we’ll help adjust your technique, reducing the chances of your pain returning.
All part of the service.