Physical Therapy or Surgery? Choosing the Best Treatment for Rotator Cuff Tears

Shoulder injuries are pretty common in the US with an estimated 200,000 rotator cuff tear repairs performed annually. Another 400,000 shoulder surgeries are performed each year for partial tears and tendinitis. But surgery isn’t always necessary nor is it your only option. Numerous studies have found that physical therapy as a treatment for rotator cuff tears to be equally as effective as surgery.

Most orthopedic surgeons would agree that taking a conservative approach and starting treatment with physical therapy is the best first step. Studies show that immediate surgery for rotator cuff tears, have the same results as waiting to perform the same surgery.  Conversely, one study found physical therapy results to be most optimal when performed early.

A 2014 Finland study found that physical therapy was equally effective in the treatment of nontraumatic rotator cuff tears when compared to arthroscopic surgery or open surgical repair.

Another study found that physical therapy was an effective treatment for full-thickness rotator cuff tears. The study involved 433 patients who were followed for five years. The patients in the study participated in a physical therapy program. Two years later, 88% of patients still did not have surgery. Those who did elect to have surgery did so within the first 12 weeks of the study launch.

Despite the findings, physical therapy isn’t the best treatment for everyone and must be evaluated on an individual basis. The best advice is to discuss physical therapy with your orthopedist and commit to the program your therapist recommends. If the pain is not minimized and function improved after 12 weeks, surgical intervention may be necessary.

Physical therapy for rotator cuff tears involves a variety of treatments, some of which include:

• Range of motion, shoulder blade stability, and rotator cuff strengthening exercises
• Joint and soft tissue mobilization, heat and cold application, electrical stimulation, ultrasound, kinesiology taping, cupping

If you have concerns about a shoulder injury, contact your physical therapist for an evaluation or schedule an appointment with an orthopedist as soon as possible. The best results come from quickly taking steps to rehabilitate the shoulder.