When Do Rotator Cuff Shoulder Injuries Absolutely Call for Surgery?

Q: When do rotator cuff injuries call for surgery?

A: The decision to have surgery for a rotator cuff injury is quite individual. In most cases, non-operative treatment will suffice.

However, if the rotator cuff tear is complete, occurring after a traumatic injury in someone who is young and active, and if it results in loss of strength and mobility, then immediate rotator cuff repair is warranted (within three to four weeks).

Partial rotator cuff tears (and even some complete tears) often can be managed without surgery. Non-operative treatment consists of physical therapy, anti-inflammatory medication and/or corticosteroid injections.

Remember to avoid overhead activities, which can exacerbate your pain.

Physical therapy involves working on range-of-motion exercises and strengthening both the rotator cuff muscles and other shoulder stabilizing muscles over three to six months.

Of course, shoulder pain does not necessarily mean a problem with the rotator cuff.

Other injuries that cause shoulder pain include:

• Shoulder arthritis.
• Adhesive capsulitis/frozen shoulder.
• Biceps tendinitis.

Treatment for these problems also moves to surgery if conservative treatment fails.

There is a lot to consider when deciding what treatment is best for a rotator cuff injury. Have an open discussion with your doctor to decide about the optimal treatment.

— Kirk Haidet, MD, orthopaedic surgeon