Shoulder Surgeon Perth | Rotator Cuff Treatment FAQ

Rotator cuff tears do extend and increase in size over time. However this process takes months and years rather than days and weeks. Quite frequently patients who have a known rotator cuff tear will have episodes of severe pain and weakness following a minor injury. It is possible that these episodes are caused by an increase in the size of the tendon tear. The tear can increase in size even without re-injury.

In general terms, if the shoulder is continuing to be a cause of pain and if the weakness is increasing then specialist review is indicated and surgery may be a consideration. Exercise that is pain free is unlikely to be causing further damage in itself.

All patients diagnosed with a rotator cuff tear should be reviewed by an orthopaedic surgeon. It may be necessary to undertake further testing including an MRI scan to accurately define the size of the tear and the age of the tear. Furthermore, if surgery is required then it may be preferable to have the surgery sooner rather than later to achieve optimal results.

If non-surgical treatment is decided upon, the surgeon can suggest alternative treatment options to help with pain.

No, not usually. Rotator cuff tears have very limited capacity to heal themselves. Once the tendon tears it pulls away from the bone and starts retracting. The tendon cannot cross that gap to allow it to heal back onto the bone on its own.

However some rotator cuff tears are treated non-surgically and the pain can settle with simple treatments. If the tear remains pain free and allows a good range of motion and adequate function then surgery may not be indicated. Small tears within the tendon (insubstance tears) may persist indefinitely without causing problems.

The problem that most commonly causes patients to undergo surgical repair for a rotator cuff tear is pain. In particular when the pain starts to interfere with sleep then some form of treatment generally becomes critical. Other factors indicating that surgery is likely to be required would include reduced ability to lift the arm or significant weakness in the arm.

Rotator cuff tearing at a young age is a strong indication for surgery. That’s because we know the tear will increase in size over time. If left for too long, it can retract to the point where it is not repairable.

If you are undertaking high demand work or sporting activities then surgery is more likely to be required.