Would you recommend surgery for rotator cuff tears?

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Caravaggio

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Aug 3, 2013
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Repoman0 has a question about exercise for shoulder dislocation but this is about tears to the cuff which I believe are very common.

Have you had, (or have you ever met someone who underwent) a completely successful surgical repair for a torn cuff tendon or muscle?

I have a minor tear which is not responding to physiotherapy. People have suggested cortisone injections, a change of therapist and surgery. My doctor claims that surgery has a long recovery time and high failure rates. My physiotherapist disagrees.

Can anyone advise, please.
 
Mar 22, 2002
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Cortisone injections are not the answer - they are almost always temporary relief of symptoms without addressing the problem. In conjunction with good physiotherapy, cortisone shots can actually be useful as they can allow for more vigorous intervention. When it comes to surgery, listen to the physician. If you're concerned about it, bring all your records, xrays, MRIs, etc to another orthpedic surgeon and listen to their opinion. Some physiotherapists aren't well versed in current surgeries (I'm a physiotherapist and I say this because some of my colleagues aren't super knowledgeable in this aspect).
 

highland145

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Oct 12, 2009
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S.C., can a PT give a good evaluation on the cuff? Asking because I can get into my PT way quicker and cheaper than I can my ortho...he's 6 weeks out
 

Caravaggio

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Many thanks SC. I'm grateful to hear from someone who has seen many of these.

Cortisone injections are not the answer - they are almost always temporary relief of symptoms without addressing the problem.

You agree with several people I have talked to about this condition. Some have had cortisone and the pain relief has been astounding. But this has given so much over-confidence that they have overdone the exercises and re-injured themselves. My physio says that it can actually weaken tendons in the long run.
I would sooner put up with a bit of pain than lose function, if that is the case.


When it comes to surgery, listen to the physician. If you're concerned about it, bring all your records, xrays, MRIs, etc to another orthpedic surgeon and listen to their opinion.
I shall take your advice.
 
Mar 22, 2002
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S.C., can a PT give a good evaluation on the cuff? Asking because I can get into my PT way quicker and cheaper than I can my ortho...he's 6 weeks out

If it truly is the rotator cuff, then yes. However, there's a lot of stuff in the shoulder. Manual special tests (the hands on tests stressing particular tissues) are not good for things like labrum tears. They are quite good for rotator cuff tears. It's a yes or no kinda thing though. Special tests can't tell us if they're actually partially torn very reliably. It's usually yes it's torn, no it's not, or the gray area in between.
 

Caravaggio

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Aug 3, 2013
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To SC,
The PT thinks my tear is in the region of the Supraspinatus attachment to the head of the humerus. He makes this judgment on the basis of my pain arc and limitation to arm movement.
Can ultrasound reveal that injury site, given that the deltoid and bursa will be in the way? If not, what sort of scan should I ask for?
Thanks.
 

taq8ojh

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Mar 2, 2013
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From my own personal experience, there's nothing but surgery to help with torn stuff, especially the shoulder, which is one hell of a bitch system to malfunction.

I had semi-successful surgery a bit over two years ago, torn (edit: I correct myself, it was a partial tear of the tendon) musculus supraspinatus (where it passes through the bones). It was probably caused by bad luck (too little room between the bones) and extremely shitty workout technique that stuck with me for years. I was running around with it for at least five years, because I never thought it could be something so serious, and later on when I did, I couldn't find non-retarded doctor. In fact I ran into complete idiots few times in a row (one even talked me into these injections of your own blood plasma, which cost me a fortune and didn't help anything, which was pretty normal, as I was told later by others)
By the time I found one that would operate me, it was almost too late, in that I can't turn the arm in specific way without pain, and the range of motion is not what it once was. It beats not being able to pick up a chair without pissing yourself from the agonizing pain, though.

The morale of the TL;DR story is: don't do the same mistake I did, and immediately go under the knife, if you can. The longer you wait, the worse the result can be (but it would never be as bad as at the beginning, trust me - unless the surgeon is drunk or stoned or something :p).

Hope this helps you decide.

P.S. Ultrasound doesn't help, you gotta get MRI.
 
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