Can I heal my rotator cuff injury without surgery? I fell a couple of months ago and tore my rotator cuff muscle. The dr. Says I need surgery, but I am hesitant, because that would mean a long recovery. I am self-employed and I can't make a living witho

I . I agree with dr. Peterson. Depending on type of rotator cuff tear, physical therapy is often an excellent option. By maximizing the muscle strength of the surrounding the other rotator cuff muscles and surrounding shoulder blade muscles, the pain associated with the tear and subsequent dysfunction may be controlled. For those who do not have success with physical therapy, surgery may improve their results. Physical therapy seems to do a little better in the degenerative type tears or the partial thickness rotator cuff tears. Usually, large full thickness rotator cuff tears tend to require surgical repair.
Omaha, . Omaha, your concerns regarding recovery and it's effects on your livelihood are extremely important in the decision making process. In the past few years, I have noted an increasing level of awareness about the length of recovery and the downside of limited activity. As you make your decision about how to maximize your recovery and minimize your down time, you are asking many important questions. In this regard, i essentially agree with all the advice you have been provided in the other fine answers. Specifically, the time line to maximal recovery and impact on your life and work will depend on several factors. Principally the pre-injury condition of your shoulder and the nature and extent of the current tear. Also if this your dominant arm and what kind of work you do specifically. If this is a new tear in an otherwise healthy shoulder a full symptomatic recovery can be expected. This may occur with rehab exercises and time (a few months) if the tear is small and partial thickness although this is not always the case as not everyone responds in this manner. In that case, or if your injury is larger and full thickness, surgery is the only method to restore the anatomy and reconnect the tendon to your bone. After surgery, depending on the size of your tear, your general health, the skill of your surgeon and success and compliance with rehab, return to work can be anywhere from a week or 2 to as much 4- 6 months. The range in return to work is very much dependent on what you do for a living. If you are a laborer, carrying and moving objects or a surgeon for example. It will take about 4 months (+/- 2) depending on the size of the tear and the success with your rehab. If you have a desk type job with minimal lifting, most folks can start typing in about 1-2 weeks and performing for a full day after about 2 weeks. Of course this assumes that you no longer require narcotic pain medication as this can effect your decision making. Patients tend to vary in this requirement, but I have seen many folks who discontinue pain medication after cuff repair surgery within the first 2 weeks, only needing it at nite for help sleeping or after a pt session. Of course if it is your dominant arm and you are a baseball pitcher the situation is very different as your recovery demands would be much greater for full performance. As for your question about "steroids" and "self healing". In general injections like steroids reduce the ability of tissue to heal by reducing inflammation. Although this often makes the shoulder feel much better, it often masks the symptoms of the tear. This can have benefit, like improved ability to do physical therapy and return to work. However, I am very careful in using steroids in the shoulder, because if one masks a true rotator cuff tear and if the tear is present for too long, it can increase in size and actually become unrepairable in worst cases. As such, i reserve the use of steroids injections for folks with "impingement syndrome" and no tears and others who have a frozen shoulder, a seperate condition beyond the scope of your questions. I hope this is helpful. Good luck dennis c. Crawford md, phd.
Often, . Often, rotator cuff tears can become "asymptomatic" with physical therapy and nsaids. However, they do not "heal". Most acute traumatic tears require a surgery and do well with appropriate rehab. While it is difficult to follow the post-op limitations, most patients are happy with their results.