If you have a rotator cuff tear, trying to make decisions about what type of treatment you should have can be difficult. Some research will say that it is not the tear that is painful, but the inflammation in the surrounding bursa. Some patients are told that they need surgery to stop the tear getting bigger. Recent research from Norway, shows that while this is true in some cases, people who have only a small increase in tear size, still have normal function and minimal pain up to 8 years later.
These researchers looked at 49 people who had small to medium sized cuff tears over 8 years ago and investigated what had happened to their tears over this time. These people all had an MRI at the time of their injury and the tear was reported as less than 3 cm, did not involve subscapularis and limited fatty degeneration. The results showed that while the tears did get larger, only people whose tears increased by more than 20mm (16%) were associated with decreased strength and poorer levels of function. Most people (69%) had small increases in the size of the tear (less than 10mm), and these people still had normal range of movement when lifting overhead, and an average pain score of 1/10. People who had an increase of more than 20mm in the size of their tear, had worse levels of function, more pain (average 5.5/10) and worse shoulder strength.
The researchers concluded that physiotherapy treatment should be recommended for rotator cuff tears that are less than 3cm, that do not involve the subscapularis tendon, and have no muscle atrophy or degeneration.
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