Few Rotator Cuff Tears Worsen Over Time

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Previous research has found no significant difference at either 1 or 2 year follow up between Physical Therapy or surgery for rotator cuff tears.  One disproven argument you may still hear against the conservative care of these tears is they may worsen over time including larger tear sizes or further movement of the torn ends (retraction) limiting surgical effectiveness.  This is a logical thought until we consider what the research shows on the progression of these tears.

An article in the American Journal of Sports Medicine followed 362 patients with high grade partial rotator cuff tears to determine the natural progression or regression of these tears over time.  These patients were followed with conservative care including Physical Therapy for up to one year before undergoing a second MRI scan to determine if there were any changes in the torn tendon.  81 patients underwent the second MRI scan.  The authors reported only 16% of patients had a progression of their tear.  Conversely, 60% of patients showed no change in the tear size and 25% of tears improved over time.  Authors stated "decisions to undertake surgery at the time of presentation may be excessive".  

This study highlights the importance of using Physical Therapy first for rotator cuff tears.  Schedule your first appointment with the experts at MEND now/