Rotator cuff tears do not heal on their own without surgery, but many patients can improve functionally and decrease pain with nonsurgical treatment by strengthening their shoulder muscles. Just because there is a tear, does not necessarily mean a surgery is needed.
Probably people can resume their activities like playing sports after six months. However, a complete recovery from a rotator cuff tear might take up to a year in some cases. There is no need to reconnect a partially torn tissue to the bone to regain its full range of motion.
If left untreated, a rotator cuff tear can severely restrict function and range of motion. The tear can also increase over time. This may cause partial rotator cuff tears to progress to total tears.
Even though most tears cannot heal on their own, you can often achieve good function without surgery. If, however, you are active or use your arm for overhead work or sports, surgery is most often recommended because many tears will not heal without surgery.
Typically tears occur in those over age 40, but occasionally tears are seen in younger individuals. Typical signs of a rotator cuff tear include pain with overhead use of the arm, weakness or pain preventing or disrupting sleep.
There are a few key differences between a rotator cuff strain and tear. A rotator cuff strain is a stretching or micro-tearing of the tendons and muscles surrounding the shoulder joint while a tear is a complete or partial tearing of one or more of the tendons in the shoulder.
Before exercising, warm up your muscles and tendons in a warm shower or with a heating pad. You may experience some mild soreness with muscle-toning exercises — ice applied to the shoulder should help relieve it — but if you develop sharp or severe pain, stop the exercises for a few days.
The Lateral Jobe Test is actually one of the most reliable tests for a rotator cuff injury, and you may need an assistant again to help administer this test. This test also looks for weakness in the supraspinatus muscle.
It is very uncommon to operate on a partial rotator cuff tear. In cases of deep partial tears — when more than 90 percent of the tendon is torn — surgery is recommended only if the symptoms can't be controlled with nonsurgical treatments.
Patients with “well-balanced” massive rotator cuff tears may still have good active motion and be able to perform their activities of daily living. This is usually achieved through balanced force coupling across the glenohumeral joint (intact subscapularis and teres minor) and recruitment of the deltoid muscle.
Without any treatment—either rest and rehabilitation or surgery—rotator cuff disorders may get worse. Over time, you may have more pain. You may lose range of motion and strength in your shoulder, making it harder to do your daily activities.
Patients are often advised to wear a sling or brace for the first 4–6 weeks after rotator cuff repair surgery to prevent them from performing any physical activities involving the affected shoulder (3).
Moist heat, such as a hot bath, shower, or a heat pack, can help loosen up your shoulder when you feel pain in your shoulder. An ice pack applied to the shoulder 20 minutes at a time, 3 to 4 times a day, may also help cut down the swelling when you are in pain. Wrap the ice pack in a clean towel or cloth.
Ultrasound is an increasingly utilized method for diagnosing rotator cuff injuries and other soft tissue injuries of the shoulders. Unlike X-rays, ultrasound allows the doctor to identify different soft tissues (e.g. muscles); it can be performed in the doctor's office; and no radiation is delivered to the patient.
The pain associated with a rotator cuff injury may: Be described as a dull ache deep in the shoulder. Disturb sleep. Make it difficult to comb your hair or reach behind your back.
Treatment. If your tear came from repeated use, then you may be able to manage your rotator cuff injury without undergoing surgery. You might be asked to wear a sling to keep your arm from moving. Allowing your arm and shoulder to rest properly is important in allowing your rotator cuff to heal.
Bodyweight exercises such as a push up can also be performed if you have rotator cuff related pain. It is a great exercise that can challenge the rotator cuff muscles, shoulders, chest, and triceps. Here is a video with easy-to-hard push up options that you can choose from to help with your shoulder rehabilitation.
Overhead Activity Leads to Shoulder Injuries
“Any time your arms are raised up over your head, the rotator cuff might be in an awkward position,” said Dr. Wittstein, a Duke orthopaedic surgeon. “This in combination with lifting or lowering something heavy away from the body really strains the rotator cuff.”
Lateral Jobe Test
Then rotate your arm so that your palm faces backward and your thumb is facing down. Now your helper will apply a downward force on that arm, while you resist that force. If you find that resisting the downward force is difficult and painful – that is almost a sure sign of a rotator cuff injury.
Rotator Cuff Pain Symptoms
Sharp or aching pain and swelling located over the front or outside (lateral) part of the shoulder and upper arm (usually due to tendinitis or a rotator cuff tear).
When the rate of breaking down exceeds the ability of the tendon to rebuild, micro tears occur causing pain and inflammation. This inflammation is known as tendonitis. In the extreme case, this inflammation can result in the failure of the tendon known as a rotator cuff tear.