Rotator Cuff Treatment - FAQ

Rotator cuff tears are a very common source of shoulder pain. Below you'll find a list of frequently asked questions about rotator cuff treatment. 

Dr. David Colvin, trained in orthopaedic surgery in Perth.
David's specialty is knee and shoulder surgery and sports injuries.

If I have a rotator cuff tear and I keep using the shoulder, will it cause further tearing?

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.

When should I see an orthopaedic surgeon for a rotator cuff tear?

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. 

Can a torn shoulder tendon heal itself?

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. 

Does a rotator cuff tear require surgery?

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.

What rehabilitation is required following rotator cuff repair surgery?

Getting the rehabilitation right is as important as the surgery itself.  The rehabilitation treads a fine path between the importance of getting the shoulder moving quickly to prevent a post-operative frozen shoulder, and on the other hand not stressing the tendon repair to the point where it is damaged.  There is a well established and accepted protocol for rehabilitation following rotator cuff repair.  It is advisable to have a physiotherapist involved in your rehabilitation. This is to ensure that you are reaching the appropriate goals and undertaking appropriate exercises for your point in the recovery timeline.  The physiotherapists main role is to instruct you in the exercises.  Hands on physiotherapy is not as crucial.  The bulk of the rehabilitation involves you undertaking exercises at home on your own time on a regular basis in order to achieve improvements in movement and strength. 

How long do I need to wear a sling after rotator cuff repair?

Usually four to six weeks depending on the size of the tear.

How soon can I drive after rotator cuff surgery?

Driving is usually restricted for a period of six weeks. This is necessary both to protect the repair and also for legal reasons.

When can I return to work after rotator cuff repair?

You can return to office and supervisory duties using the non-operated arm approximately ten days after surgery.  Light lifting up to half a kilogram to bench level is permitted six weeks after surgery.  Moderate lifting can resume three months after surgery.  Physically demanding occupations resume somewhere between six and twelve months after surgery.

When can I play sport after rotator cuff repair?

  • Running can start four months post rotator cuff repair surgery.
  • Breaststroke swimming at four months, swimming with fins at five months and freestyle at six months.
  • With golf, you can chip and putt at four months, hit irons on the practice range at five months and normal play at six months post surgery.
  • Social tennis is usually possible six months post surgery.

Rotator Cuff Tear

Shoulder pain is a common complaint in our community. For younger people, shoulder pain is usually the result of an accident or injury. In older patients, it can be a natural wear and tear process. A rotator cuff injury is a common cause of shoulder pain, and is due to a strain or tear in the muscles or tendons of your shoulder.

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Rotator Cuff Repair

When the rotator cuff tendons of the shoulder tear, they pull away from their attachment to the bone. Once the tendon is detached from the bone, it starts retracting due to the pull of the rotator cuff muscles. In this situation, a gap develops, and the tear cannot heal of its own accord as the tendons cannot bridge a gap.
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About Dr. Colvin

Not everyone requires surgery as a first line of treatment. We may explore other options first: treatment may consist of exercise, physiotherapy sessions, injections or medication.
My role is to make sure that you maintain a high level of motivation. It is an essential component of successful surgery and rehabilitation.

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Suite 213/25 McCourt St,
Subiaco WA 6008

OPENING HOURS

Monday to Friday 8:30am to 5.00pm AWST

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Dr David Colvin consults at:
Western Orthopaedic Clinic

  • These rooms are part of St John of God Subiaco Hospital.
  • Parking is available on site.

OPERATING

Dr David Colvin operates at:
St John of God Subiaco Hospital
12 Salvado Rd,
Subiaco WA 6008