Many often wonder is surgery necessary for a rotator cuff tear? The answer is IT DEPENDS.

What does it depend upon?

Well for starters the size of the tear. Small Tears of the rotator cuff are quite common in individuals as they age and DO NOT necessarily have an impact on function (Keener et al). This is contrary to what most belief, but there are thousands of individuals right now who have small tears and are completely unaware (Minagawa et al). This suggests small tears are part of normal aging and nothing to worry about (even if temporarily painful).

Also to be considered is pain and function of the individual. If pain is minimal and function is good – why consider surgery? Understand that if surgery is performed, the person is likely to be in a sling for 2-6 weeks and then still have reduced usage, range, and strength up to 12-16 weeks. So…if able to function well and not painful, is that worth it. Also understand, there is a small potential to be worse after “corrective” surgery…it happens.

Finally, what does the individual wish to return to? Those just looking to complete activities of daily living may be just fine as compared to a person needing to perform heavy tasks with their shoulders. This may or may not be age related.

On the flip side, even if a person has a large tear, it does not necessarily mean surgery is a must. There is a percentage of individuals who can function surprisingly well even with a large tear. That said, the individual must weigh the risks and benefits of any surgery.

A good first step for any person concerned about potential for or even if a confirmed tear is to undergo a bout of conservative care. There is the potential to maximize shoulder motion, strength, and function while avoiding surgery. And in the end if it does not achieve the desired outcome, surgery remains a last resort.

So…

If looking to avoid surgery, a good first step is to see a person who specializes in helping individuals regain lost motion and function conservatively. To get more answers on how – fill out this quick form describing the problem.

References:

Keener et al. Asymptomatic rotator cuff tears: Patient demographics and baseline shoulder function. J Shoulder Elbow Surg 2010;19:1191-1198

Minagawa et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. J Orthop 2013;10:8-12.