Rotator cuff tears do not always cause symptoms. If you are having symptoms from your RTC tear and don’t treat it, it is possible that your pain levels can increase and the function of the shoulder may decrease.
Many people have asymptomatic full-thickness rotator cuff tears. This has been shown conclusively in the research and surgery should oftentimes not be the first line of treatment.
Physical therapy can be a great way to help improve the function of the shoulder and to relieve pain.
Often times functional increase and pain decrease takes 6 weeks up to 6 months. Too often, I see clients give up on exercise at 6 weeks and opt for surgery.
If we look at the success rate of RTC surgeries compared to physical therapy, the results aren’t great.
There is a high re-tear rate and the recovery from surgery is quite difficult. With this being said, some individuals will need to get the surgery done but many do not.
This is still one of the most overutilized surgical procedures still done.
In the rest of this article i’ll share with you a few more answers to common questions you might have about surgery, how long you can without surgery, or if you need it at all. Let’s dive in!
How Long Can You Go Without Surgery For a Rotator Cuff Tear?
Forever. You can literally go your entire life with a rotator cuff tear and not need surgery.
Some individuals as discussed above will require surgery, however, many will benefit from seeing a physical therapist, going through a rehab plan for a few months, and then implementing a normal strength training routine as recommended by the American Academy of Sports Medicine.
Can you live with a fully torn rotator cuff?
Yes, you can live with a fully torn rotator cuff.
You might also be wondering what happens if you don’t fix an RTC tear… well, it doesn’t really matter if you don’t have increasing symptoms and your function is fine.
Here’s the thing. People think that if you have a tear somewhere in your body that this means it needs to be fixed.
This is outdated thinking from the 20th century.
We have plenty of new data and patient experience, showing that people who have rotator cuff tears, meniscal tears, osteoarthritis, and even ACL tears can live a completely functional and normal life without having these areas repaired.
The most important thing with any tear that’s been confirmed via MRI or x-ray is to get evaluated and see what your symptoms and functions are like.
If you can increase your function and decrease your symptoms without surgery then logically why would you need surgery?
You might be thinking that “well, if the tear is there, doesn’t that mean that I’m at a higher risk of pain and decreased function? Won’t it just get aggravated more often?”
Nope.
It just doesn’t work like that. Sure, you might get some shoulder pain here and there, but that’s just like the rest of the population with and without an RTC tear.
Does a rotator cuff tear need to reattach naturally or with surgery for it to have less or no pain?
No, the rotator cuff does not need to be reattached in order for symptoms to reduce or go away completely.
While tears can be symptomatic, our body can also adapt to having tears in different areas thereby reducing symptoms and increasing function.
The mechanisms behind this are unclear as pain is a very complex phenomenon.
Are rotator cuff tears more common as we get older?
Yes, they are common as we get older!
A high percentage of individuals 50 and older have full-thickness rotator cuff tears and don’t even know it.
This does not put them at a higher risk of developing a pain or disability.
Does a torn rotator cuff hurt all the time?
This depends on the person. Some people will have dull and achy pain all the time with an RTC tear while others will only have intermittent symptoms.
Some individuals may have no pain at all.
Will a cortisone injection help a torn rotator cuff?
A cortisone injection may help with symptoms related to a torn rotator cuff if there is a significant amount of inflammation.
It’s not recommended to get more than 3-4 corticosteroid injections in one year due to the possible joint-damaging and tendon-damaging effects it can have.
If you’re wondering whether a cortisone injection will help actually heal the torn RTC tendon and reattach it’s insertion point on the bone, no, this is not happening. Nothing will do that other than surgery.
Key Takeaways
- Rotator cuff tears are very common and they increase in commonality as we get older
- You can live with a torn rotator cuff and not even know it
- A cortisone injection may help with symptoms related to shoulder pain however it is not going to heal tissue.