The treatment of a rotator cuff injury depends on several factors, including the severity of the tear, the patient’s symptoms, functional goals, and overall health. Here are some common treatment options for rotator cuff injuries:
Non-Surgical Treatment
CAVEAT for Non-Surgical Treatment – This is meant for very minor tears of the rotator cuff tendon or small partial tears where surgery is not indicated.
If there is a sizable full thickness tendon tear, surgery IS needed and recommended. If left alone, the tendon will tear further over time and it might become irreparable. This can eventually result in cuff arthropathy (osteoarthritis of the shoulder joint) or in pseudoparalysis of that arm.
Rest and activity modification
Avoiding activities that exacerbate symptoms and modifying daily activities to reduce strain on the shoulder can promote healing.
Physical therapy
A structured physical therapy program can help strengthen the surrounding shoulder muscles, improve range of motion, and alleviate pain. Therapeutic exercises, manual therapy techniques, and modalities like ultrasound or electrical stimulation may be employed.
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) or pain-relieving medications may be prescribed to reduce pain and inflammation associated with the rotator cuff injury.
Corticosteroid injections: In some cases, corticosteroid injections may be recommended to provide temporary pain relief and reduce inflammation.
Surgical Treatment
Partial-thickness tears
If the rotator cuff tear is partial thickness and causing persistent symptoms despite non-surgical treatment, arthroscopic debridement may be performed. This involves removing the damaged tissue and smoothing the remaining tendon. Surgical application of an allograft patch of tissue on the tendon can also help with tendon healing in partial tears.
Full-thickness tears
Surgical repair is often recommended for full-thickness rotator cuff tears. The specific surgical technique will depend on factors such as tear size, location, tissue quality, and patient characteristics.
Arthroscopic repair
Small incisions are made, and an arthroscope is inserted to visualise and repair the torn tendon using sutures or anchors.
Open repair
A larger incision is made to directly access and repair the torn tendon. This technique may be preferred for larger or more complex tears. This is now uncommonly performed.
Mini-open repair
A hybrid approach that combines aspects of both arthroscopic and open surgery.
In cases of irreparable tears, where the tendon cannot be repaired, alternative procedures like tendon transfers or superior capsular reconstruction may be considered.
The choice of treatment depends on various factors, including tear size, location, patient symptoms, functional goals, and the surgeon’s expertise. It’s important to consult with a qualified orthopaedic surgeon or shoulder specialist who can evaluate your specific condition and recommend the most appropriate treatment option for you.
Rehabilitation and post-operative care, including physical therapy, are often crucial components of both non-surgical and surgical treatment plans. They help optimise shoulder function, promote healing, and prevent future injuries.
