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Surgery or physical therapy: which is best for a tear to my rotator cuff?

Acute pain in a woman shoulder. Female holding hand to spot of sWhile every case is unique, the questions you should ask the surgeon are not.

  1. What will happen if I just wait out the pain?
  2. If I try physical therapy first, am I hurting the chances of a positive outcome from surgery?

In The Bone & Joint Journal, January 2014, a study by lead author J. Kukkonen looked at patients who had an isolated rotator cuff tear at the supraspinatus tendon that started without a clear trauma or injury (i.e., a fall, a motor vehicle accident, etc.). This study was conducted by a group of physicians who were looking to support the superiority of surgical repair to physical therapy. To their surprise, at one year both the surgical and the physical therapy groups were the same in pain levels and function.
Several MRI studies have shown that 30-40% of rotator cuff tears do not result in symptoms of pain or weakness. However, tears can lead to a very painful shoulder–inflammation, inadequate range of motion , and poor strength. Whether or not your tear is symptomatic, it is not clear that either surgery or physical therapy results in better outcomes.
If you would like to try non-surgical intervention, whether physical therapy or simply rest, we at Apex Orthopedic Rehabilitation  can advise and treat you. We work closely with local orthopedic surgeons to understand in each case whether surgery is indicated, or if the more conservative intervention of physical therapy is recommended.
Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, and Bergen County region.  This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.

Tom Willemann

Tom Willemann

Tom Willemann is a premier physical therapist based out of Bergen County, New Jersey. He holds an MS in physical therapy from the University of Miami, is credentialed in the world-renowned McKenzie Method of Mechanical Diagnosis and Therapy (MDT), and holds an OCS (Orthopedic Clinical Specialist) certification. As of 2018, there are approximately 14,000 ABPTS certified specialists in the nation and less than 400 of them are located in the state of New Jersey. Tom is the owner and director of Apex Orthopedic Rehabilitation in Paramus. He opened the clinic, which specializes in spine and sports injury prevention, in 2004 after many years of experience in the field. Tom’s caring interest in others and his strong belief in continuity of care, combined with his clinic’s ability to find solutions for the most difficult orthopedic problems, have earned Apex Orthopedic Rehabilitation its excellent reputation with patients and medical professionals in northeastern New Jersey and beyond. A true “family man,” Tom takes pride in his clinic’s warm and welcoming environment.
Tom Willemann

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