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 JULY 31,2013 Rotator Cuff Care: You May Only Need Physical Therapy Most patients with rotator cuff injuries respond well to physical therapy and don't need surgery, according to new research into repairing shoulders. Every year, about 200,000 Americans undergo shoulder surgery related to repairing the rotator cuff, a set of four small muscles in the shoulder that helps to lift and rotate the arm. Treatments to repair the rotator cuff include anti-inflammatory agents, steroid injections, surgery, physical therapy, or a combination of the above. The best option may simply be physical therapy, says John E. Kuhn, MD, Chief of Shoulder Surgery at Vanderbilt University Medical Center. After surgery "it usually takes people about four months before they can even think to get back to any kind of labor-type work and it usually takes a year to get a full recovery,” says Kuhn, who is the director of the Moon Shoulder Group, a network of doctors researching the best options for repairing shoulders. "We found exercise programs were effective at treating rotator cuff disease and we consolidated them into one physical therapy program," says Kuhn. The program focuses on range of motion, flexibility, and strengthening. The therapy program doesn't necessarily heal the rotator cuff, but it does take the pain away, he says. Kuhn led a new study of 452 rotator cuff tear patients and found the exercise program helped 85% avoid surgery. The study appeared in the May issue of the Journal of Shoulder and Elbow Surgery. The effect lasted for 2 years, and only 2 percent of the patients opted for surgery. The study also suggests that pain may be a less suitable indication for surgery than weakness or loss of function. The entire rotator cuff home exercise program is available for free online. Kuhn suggests you talk to your physician before starting it. When to see your doctor Here are some indications you may need to see your doctor for a rotator cuff problem, says Jeffrey H. Yormak, MD, a board-certified orthopaedic surgeon with Somers Orthopaedic Surgery & Sports Medicine Group: • Pain in the front of your shoulder that radiates down the side of your arm. • Weakness in your arm and difficulty with routine activities. • Difficulty with routine activities, including combing your hair or reaching behind your back. "If you've injured your shoulder or experience chronic, lasting shoulder and arm pain, it's best to see an orthopedic surgeon," Yormak says. "Only then can you receive a definitive diagnosis and begin treatment. Early diagnosis and treatment of a rotator cuff tear may stop symptoms, such as loss of strength and motion, from setting in." |
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