Non-Operative Physical Therapy Treatment of Rotator Cuff Tears

By: Tina Memarzadeh, SPT

 

SHLDR

 

Rotator cuff tears affect at least 10% of individuals over the age of 60 in the United States, which accounts to roughly 5.7 million people.1, 2 An estimate of 75,000-250,000 rotator cuff surgeries are done per year, indicating that only 5% of patients with rotator cuff tears are being treated surgically.3 A number of recent studies suggest non-operative treatment of full thickness rotator cuff tears can be successful in some patients.4  Research shows that physical therapy alone can produce results equal to those produced by arthroscopic surgery and open surgical repair.

 

 

Many researchers have worked on creating an effective physical therapy protocol in treating rotator cuff tears non-operatively. Of note, is the Multicenter Orthopaedic Outcomes Network (MOON), a group of doctors from around the country focusing on research to enhance care of patients with shoulder problems. MOON shoulder group has developed a set of protocols to be used by physical therapists and at home by patients to treat non-traumatic rotator cuff tears. Study done by the MOON shoulder group demonstrated greater than 85% success rate using their physical therapy protocol, with the beneficial effects of this program lasting for a minimum of 2 years.5

 

 

The home therapy program created by MOON shoulder group is used to compliment a therapist directed program. Therapists will guide patients through a protocol which consists of three parts:

  1. Range of motion: done every day to get shoulder motion back
  2. Flexibility: done every day to stretch tight tissues
  3. Strengthening: done 3 times per week to regain strength

 

 

Example of range of motion exercises include pendulum exercises, posture exercises, active assisted range of motion exercises using unaffected shoulder, active training of the shoulder blade muscles, and active range of motion exercises. Flexibility exercises include door stretch, sleeper stretch, golfer stretch, and towel stretch. Lastly, examples of strengthening exercises are isometrically activating rotator cuff muscles against a wall, shoulder internal and external rotator strengthening using elastic bands or dumbbell, rowing using elastic bands, chair press ups, shoulder shrugs, shoulder blade push-ups, and Jackin’s exercises.

 

 

 

To learn more about physical therapy to treat rotator cuff motion and strength deficits, contact us at info@sptny.com.

 

References:

  1. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ Ann R Coll Surg Engl. 2006 Mar; 88(2):116-21
  2. Werner CA. The older population: 2010, US Census Briefs, C201 OBR-09. US Department of Commerce, Economics and Statistics Administration, US Census Bureau. 2011 Nov; 1–19. ( http://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf
  3. Rotator cuff repair: an analysis of utility scores and cost-effectiveness. Vitale MA, Vitale MG, Zivin JG, Braman JP, Bigliani LU, Flatow EL J Shoulder Elbow Surg. 2007 Mar-Apr; 16(2):181-7.
  4. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: A randomised controlled study of 103 patients with one-year follow-up. Moosmayer S, Lund G, Seljom U, Svege I, Hennig T, Tariq R, Smith HJ J Bone Joint Surg Br. 2010 Jan; 92(1):83-91.
  5. Kuhn JE, Dunn WR, Sanders R, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg. 2013; 22(10):1371-9.

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