Our clinical team at Physiohaus optimizes treatment for all types of rotator cuff tears of the shoulder. A well designed and executed rehabilitation program delivers excellent results for the vast majority of patients. It is well known that if patients participate in an appropriate rehab program for 6-12 weeks, 85% of them will do as well or better than if they had the tear surgically repaired. An important factor is finding a skilled and experienced clinician to treat your shoulder.

Rotator cuff tears are very common. In fact, imaging studies have shown that about 40% of people over 50 of people have a rotator cuff tear. Not all tears cause pain or weakness though, so much of the population is walking around with a tear that they are unaware of. Approximately one third of non-symptomatic tears will eventually become painful.

Causes of Rotator Cuff Tears

There are two main types of rotator cuff tears: 1) traumatic and 2) degenerative

1) Traumatic tears occur quickly when the strain on the rotator cuff exceeds its strength and the tissue fails. These tears are sudden and often painful so the patient "knows" that they have injured their shoulder. Typically, there is a quick loss of function with an onset of pain.

2) Degenerative rotator cuff tears have multiple causes that can be categorized as factors that are extrinsic (outside of) to the tendon and intrinsic (inside of) to the tendon.

External Factors Effecting Rotator Cuff Tears
– Impingement of the rotator cuff at the shoulder
– Shoulder muscle imbalances
– Poor shoulder blade position and control
– Joint architecture
– History of repetitive or overhead shoulder tasks

Internal Factors Effecting Rotator Cuff Tears
– Overall tissue health
– Concurrent thyroid disease
– Genetic predisposition
– Poor blood flow to the tendon

Physiohaus Assessment of Rotator Cuff Tears

A rotator cuff tear has a different list of factors that have led to the development of the problem. This is why it is critical that recovery begins with a skilled orthopaedic therapist who will conduct a detailed assessment of your condition and design a rehab program that addresses the causes of your tear. A thorough assessment for a rotator cuff tear should consist of:

• A complete history of the shoulder problem
• A complete personal medical history to understand how other conditions might have increased your risk of injury
• Examination procedures to rule out other causes of your pain (referred pain)
• Discovery of habits that are making the problem worse
• Observation of shoulder and spinal posture in sitting and standing
• Evaluation of functional movements of the shoulder
• An examination of the rotator cuff length, strength and motor control (movement patterns)
• Examination of the strength, length and motor control of the larger muscle groups of the shoulder
• Examination of shoulder blade position, movement, strength and coordination
• Examination of rib cage and spinal mobility

Only after looking at all of this information is it possible to create a treatment plan that will focus on addressing the factors that are causing your specific problem, and optimizing your opportunity for recovery.

Physiohaus Treatment of Rotator Cuff Tears

The treatment that is recommended should match with the findings of your assessment. Your progress should be re-evaluated regularly and your treatment plan adjusted. A treatment plan may consist of some of the following;

– Stretching or strengthening of specific muscle groups to correct imbalances
– Manual therapy to correct tissue imbalances and improve shoulder mobility
– Proprioceptive exercises to improve your sense of joint position and motor control
– Spinal mobility or stability exercises
– Modification of posture
– Activity limitation / modification
– Treatment of the torn tissue itself with manual therapy and other therapeutic techniques

A well-designed program will only have the elements that will help you. Participating in a generalized or non-specific program will mean that you will be doing a lot of things that may not have any benefit to your specific impairments.

Rotator cuff tears can be very painful and debilitating. Our clinical team has extensive post graduate experience in treating shoulders. If you would like an assessment with a focus on identifying your specific path to recovery, call Physiohaus.