Heal Rotator Cuff Tears with Home Physical Therapy
By: Dr. Abe Kopolovich, DPT, MBA, JD-IP
The rotator cuff is a group of four muscles and tendons that surround the shoulder joint. They work together to keep the shoulder stable and allow for smooth movement. Unfortunately, rotator cuff tears are a common injury, especially for older people: more than two million Americans experience some type of rotator cuff problem every year.
A partial or complete rotator cuff tear makes it difficult to raise and move your arm. You may have shoulder pain and arm weakness. Rest, pain relievers and physical therapy can help. Keep reading to know how to tackle this injury and correctly recover from it.
What causes a rotator cuff tear?
An accident, such as a fall, can cause a broken collarbone or dislocated shoulder that tears the rotator cuff either partially or completely.
More commonly, rotator cuff tears occur over time as the tendon wears down with age and use (degenerative tear). People over 40 are most at risk due to degenerative reasons like bone spurs, decreased blood flow and overuse.
People with a family history of shoulder problems or rotator cuff injuries, poor posture, smokers, or those who work in professions that demand repetitive shoulder movements (carpenters, mechanics, painters, athletes, etc) are in particular risk of developing this kind of injury.
Rotator Cuff Tear Symptoms
The symptoms of a rotator cuff tear can vary depending on the severity of the case. Some common symptoms include:
- Pain when lifting or lowering the arm
- Weakness in the arm
- Difficulty reaching behind the back or above the head
- Clicking or popping sounds in the shoulder
- Shoulder pain that worsens at night or when resting your arm
- Limited range of motion
A rotator cuff tear can get worse without treatment. A complete tear can make it almost impossible to move your arm.
If you are experiencing any of these symptoms, it is important to see a shoulder pain specialist for an evaluation. The doctor will perform a physical exam and may order imaging tests such as X-rays or an MRI to confirm the diagnosis.
Nonsurgical Treatments for Rotator Cuff Tears
The treatment for a rotator cuff tear depends on the severity of the injury. For mild tears, rest, ice, and physical therapy may be enough to relieve symptoms, strengthen the shoulder muscles and promote healing.
Just because there is a tear, does not necessarily mean rotator cuff surgery is needed. About 8 out of 10 people with partial tears get better with nonsurgical treatments. It can take up to a year for the condition to improve.
Nonsurgical treatments include:
- An arm sling and rest to give your shoulder time to heal. You may need to modify activities and stop certain work or sports for a period of time.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to minimize pain and swelling.
- Physical therapy to learn strengthening and stretching exercises.
- Steroid injections to ease pain and swelling.
When is rotator cuff surgery advisable?
Your healthcare provider may recommend surgery if you have a complete tear or nonsurgical treatments don’t help a partial tear. You may also have rotator cuff surgery if your job or athletic interests affect the shoulder.
The surgery is, mostly, an outpatient procedure. You go home the same day, but the overall recovery after this surgery is very substantial.
During surgery, your healthcare provider:
- Inserts an arthroscope (small camera) through a small incision in your shoulder.
- Refers to images from the arthroscope to perform the procedure.
- Inserts tiny instruments into small incisions in your shoulder to remove bone spurs and reattach the tendon to the upper arm bone.
Some tears are not repairable due to the size and/or age of the tear, and may need reverse shoulder replacement, tendon transfer, or a debridement of scar tissue without repair.
After surgery, you need to wear a sling to immobilize your arm for four to six weeks. You can then start physical therapy. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months.
In-Home Physical Therapy for Rotator Cuff Tears
Whether you want to prevent shoulder injuries, are looking into nonsurgical treatment for a rotator cuff tear or need post-surgery exercises, home physical therapy can help you improve the health of your shoulders.
Physical therapists help people with rotator cuff tears address pain and stiffness through personalized plans, which help restore movement to the shoulder and arm, and improve their activities of daily living.
Physical therapy exercises may include range-of-motion exercises, strengthening exercises, and stretches that you can do in the comfort of your space. Therapy in Motion’s experts are eager to accompany you in your path towards wellness with the best attention and assistance straight to your door!
Contact us to learn more about our home physical therapy service and book a consultation to start working on your custom-made plans.