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Rotator Cuff Tear: Do I Need Surgery?

​The biggest fear with shoulder pain is “do I have a rotator cuff tear and does it require surgery?”. Even if you have been diagnosed with a rotator cuff tear and been advised by your physician to get surgery, you can always get a second opinion. Here are some things to consider before deciding to get surgery.

​What is the Rotator Cuff?

​The rotator cuff is a group of four muscles that stabilize the shoulder joint. They assist in rotating the shoulder, but their main job is to keep the ball (at the top of the upper arm) in the socket (of the shoulder blade).

What Causes Rotator Cuff Tears?

​Just like we get wrinkles on our skin, we get “wrinkles” inside our bodies as we age. In this case, it happens in the form of small tears in the rotator cuff. Many people go through life without even realizing that they have them because they do not have pain, so they never see it on an MRI.

We also use our shoulders every day to pick up or reach for things. This adds up to thousands of reps every week. The shoulder is a tightly packed space and if the muscles surrounding the joint are weak or not functioning properly, it can cause the rotator cuff to rub and become irritated. Over time this irritation can lead to some breakdown or tearing.

The other way that rotator cuff tears can develop is from a traumatic injury, like falling on an outstretched hand.

​Symptoms of a Rotator Cuff Tear

The first symptoms are pain around the shoulder, typically at the front of the shoulder or at the top side.

Symptoms may include:

  • Pain at front or top edge of shoulder
  • Pain with overhead activities
  • Pain at rest or at night
  • Shoulder weakness
  • Shoulder stiffness


​If surgery is suggested, then you will still be required to do physical therapy after. Most people do well with surgery and improve their function of the shoulder, but studies have found about a 20% chance of retearing the tendon.

It will be necessary for some people to get surgery right away, but for most people it is better to go through PT before electing for the surgery.

​Physical Therapy

​Physical therapy helps many people avoid the cost and burden of surgery. A trained PT can provide a thorough evaluation and help determine if you would benefit from treatment before even thinking about surgery.

Research supports exercise as an effective way to improve shoulder strength and quality of life. Physical therapists can also target weaknesses that may have caused the injury and reduce the risk of tear in the future.

​If you have a shoulder injury and want to know if you can avoid surgery, then click the link below and we can talk about your options and how we can help you!


Dr. Brett Dick

PT, DPT, Owner of Limitless Performance Physical Therapy

We Help Active People ​Improve Pain And Performance ​In Their Favorite Sports And Activities.
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