Rotator Cuff Tears Get Better With Or Without Surgery

One of the most common soft tissue injuries is a tear of one of the rotator cuff muscles.  This set of muscles helps to stabilize the shoulder by keeping the ball part of the joint firmly in the shallow socket part of the joint.  These muscles can be injured by trauma, such as falls, or by repetitive movements, such as overhead lifting.  Tears are most often seen at the tendon of the muscle and can cause significant pain and limitations in movement.  When patients are given the diagnosis of a full thickness tear (meaning that the entire width of the tendon has been affected) they are often surprised to hear that a surgical consultation is not necessary.  A recent study confirmed this.  The paper, published in the American Journal of Sports Medicine, looked at 57 trials that examined outcomes with and without surgery.  The authors concluded that patients demonstrated a consistent pattern of improvement whether they had surgery or not.  It is important to note that most patients who did not have surgery did exercises to assist in the healing process.  Given the risks inherent to any surgical procedure, it would seem to wiser to manage rotator cuff tears conservatively, even if they are full thickness tears.

Chatri, C et al (2019) The Natural History of Full Thickness Tears in Randomized Controlled Trials: A Systematic Review and Meta-analysis. American Journal of Sports Medicine. 47(7):1734-43.