Rotator cuff injuries are among the most common shoulder issues/injuries and shoulder surgeries. This is in part to the fact that the shoulder is an incredibly mobile joint and there is often not a lot of space for the rotator cuff tendons to work within. One particularly small space that often causes problems is the sub-acromion space (on top of the shoulder). (Check out the gif linked below)
When you hurt your rotator cuff the general recommendations are to rest it and ice it. If it’s bad you’ll often be told to get some imaging (x-ray, MRI, etc). If you have a tear, the next thing on your mind is surgery. However, if the tear isn’t that big or severe, doctors usually recommended you do physical therapy. Only when pain is really bad, or the tear is significant is surgical repair recommended or warranted.
Why You Hurt Your Rotator Cuff
You shouldn’t neglect the root cause of WHY you hurt your rotator cuff. Sometimes it’s a sudden injury like pruning trees overhead. But more often than not-there was an underlying issue for years and that the one event was more like the ‘straw that broke the camel’s back’.
If you get surgery without addressing the root cause-the outcomes are like playing Russian roulette.
In the World Journal of Orthopedics in 2015 researchers studied how effective rotator cuff repair surgeries were. The results were lack-luster. Researchers found that surgeries for large to massive tears failed 34-94% of time! In other words, you have a 6-66% chance of having a successful surgical outcome! That’s a HUGE range! And when you look at the higher end-that’s just over 50% successful!
However, researchers did conclude that although many surgeries were considered failures, of those failed surgeries patients still had less pain and improved ability to do the things they wanted up to 1 year after surgery. Those benefits diminished after 2 years.
Bottom line: when/if you get a rotator cuff surgery you are betting on roulette with the outcome and then it’s only about 2 years that you can enjoy the benefits from it. Sounds like a losing proposition to me.
Don’t get me wrong, there are times that surgery is needed and necessary.
Also, physical therapy does a TON of good in strengthening the weak tendons and helping restore function. I highly recommend it.
The Solution
However, more needs to be done. Often physical therapy only looks at the injury. They sometimes forget to address the injury within the broader scope of the overall environment of that injured site. Rarely does the body move in 100% isolation in the real world. You need to fix the environment so that surgery or physical therapy will work and be most effective.
This is done by training and working on your shoulder blade control, mobility, and strength training.