Previous research has documented no difference in long term outcomes between Physical Therapy and surgery for patients with rotator cuff tears. Many patients with rotator cuff tears, including massive tears, do well with conservative treatment of their shoulder injuries demonstrating improvements in pain, strength, and function. Strength training makes up the foundation of conservative care for this injury. A recent review of the evidence documents the power of strength training for patients with rotator cuff injuries.
A review of the available evidence in the International Journal of Sports Physical Therapy highlights the evidence of 35 studies examining the use of strength training for patients with rotator cuff injury (Jeanfavre et al. 2018). The authors reported on the results of strength training on 2010 shoulder with a rotator cuff tear. Further, they found 73% of these tears were greater than 1 cm and 37% were classified as massive. 37% of these tears were traumatic in nature and 58% of patients experienced symptoms greater than 1 year. Authors reported 78% of patients improved their symptoms and 85% improved their strength and function after Physical Therapy. Interestingly, only 15% of patients elected for surgery following a course of Physical Therapy highlighting the effectiveness of conservative management of this injury.