Does it hurt to twist or lift your shoulder? Does your pain get worse at night? You may have a rotator cuff injury. And, if you do, it’s important for you to understand your rotator cuff tear treatment options.
In this blog, we’ll discuss all the surgical and non-surgical rotator cuff tear treatment options available, and who could benefit from each kind of treatment.
But before we get into the details of rotator cuff tear treatments, let's make sure you understand what the rotator cuff is to begin with.
What is a rotator cuff tear?
Your rotator cuff is a group of muscles and tendons that surround your shoulder joint. They work to keep the head of your upper arm bone in your shoulder socket, and help you to raise and rotate your arm. A tear in any one of these muscles or tendons is a “rotator cuff tear.”
A rotator cuff tear is one of the most common causes of shoulder pain after arthritis.
We are more susceptible to rotator cuff injuries as we age, but they can also be caused by jobs that require repetitive overhead motions, such as painting houses, or by lifting heavy weights. They can also be caused by a traumatic accident or fall.
Rotator cuff tear symptoms
Rotator cuff tears often feel like a dull ache deep in your shoulder joint. This ache often gets worse at night and may disturb your sleep.
Rotator cuff injuries can also cause arm weakness and loss of mobility, and can make it painful or difficult to reach behind your back.
Some rotator cuff injuries don’t cause pain at all, and simply affect the range of motion. If you have pain, weakness, or mobility issues in your shoulder, it’s important to visit your doctor for a proper diagnosis before looking into rotator cuff tear treatment options.
Rotator cuff tear diagnosis
If you suspect you have a rotator cuff injury, your doctor will do a few things to arrive at an official diagnosis. First, they will ask you questions about your symptoms, so make sure you are prepared to answer questions such as:
- When did your shoulder pain start?
- What activities or movements make your shoulder pain worse?
- Have you experienced an injury to your shoulder?
- Do you have any symptoms other than pain?
- Where do you feel the pain? Does it spread down your arm or into your neck?
- Does your job aggravate your shoulder pain?
Then, your doctor will do a physical exam to test your shoulder strength and range of motion. They may also use x-rays to rule out other causes of shoulder pain, such as bone spurs or arthritis.
If they need to test further before officially diagnosing you, your doctor may recommend an ultrasound or magnetic resonance imaging (MRI) to get an inside look at your muscles and tendons. This will allow them to see if you have any tears, and if they are full or partial.
Depending on how many tears you have, and how big they are, your doctor could recommend a number of different rotator cuff tear treatment options. But what are those options? Let’s take a look at some of the most common rotator cuff tear treatments.
10 rotator cuff tear treatment options
There are many types of rotator cuff tear treatment, and the type your doctor will recommend can depend on a variety of factors, such as:
- The size of the tear
- The location of the tear
- Your unique anatomy
- The health of your tendon tissue
- Your surgeon’s experience with certain procedures
Doctors won’t always recommend surgery for your rotator cuff tear treatment. If it is just a partial tear, and you don’t use your arms overhead regularly for work or sports, you may be able to get away with non-surgical rotator cuff tear treatment.
Sometimes, tendons can heal on their own, but tendons take a long time to heal since they have very little blood flow to spread healing nutrients around. Because a rotator tear takes a long time to heal, non-surgical approaches will need to work alongside long-term rotator cuff pain treatment.
If your pain does not improve with nonsurgical methods, or your tear is severe, your doctor may recommend surgery.
Here are the 10 most common rotator cuff tear treatment options in no particular order:
1. Open tendon repair surgery
If you have a large or complex rotator cuff tear, treatment often includes open surgery. In this case, your surgeon needs a larger incision to reattach the damaged tendon to the bone.
A traditional open surgical incision is a few centimeters long. Your surgeon will likely need to detach or split your deltoid muscle to gain access to your torn tendon.
It usually takes six to eight weeks for your tendon to heal to the bone. For full recovery, you are looking at around four months for a small tear and up to 12 months for a more severe tear.
2. Arthroscopic tendon repair surgery
If your shoulder injury isn’t as complex, but still needs surgery, your surgeon may be able to perform an arthroscopic tendon repair surgery. This treatment for torn rotator cuffs reattaches your torn tendon using a tiny camera and tools inserted through small incisions.
Because the incision is much smaller and the procedure is less invasive, this can usually be performed as an outpatient procedure. Of course, your tendon will still need time to heal to the bone, so you are looking at a recovery period of four to six months.
3. Tendon transfer surgery
Sometimes, you need a more drastic rotator cuff tear treatment to see a full recovery. This will be the case if your torn tendon is too damaged to be reattached to your arm bone.
If you cannot use traditional open surgery or arthroscopic treatment for torn rotator cuffs, your doctor may recommend a tendon transfer surgery. This is when a healthy tendon in your shoulder has its attachment moved to the injured area so your joint can function properly again.
Tendon transfer surgery has a similar recovery time to open shoulder surgery.
4. Shoulder replacement surgery
In the very worst case, your rotator cuff tear treatment may involve a full shoulder replacement. This is very rare, and doctors will only resort to this if there are massive rotator cuff injuries that require a full replacement to improve the joint’s stability and function.
After surgery, you will need to keep your shoulder in a sling for the first six weeks. After that, you can start physical therapy and a gradual return to your normal routine. Full recovery may take a year or more after surgery, but most people regain normal shoulder function after about six months.
5. Biologic and regenerative therapies
Biologic and regenerative therapies, such as platelet-rich plasma (PRP) and stem cell injections, are innovative approaches designed to harness the body's natural healing processes for tissue repair.
While these treatments are still under investigation and may not be universally accepted, they show promise in promoting healing, especially in cases like rotator cuff tear treatment.
PRP is derived from your blood. The platelets contain growth factors and other bioactive proteins that play a crucial role in the healing process. By introducing a high concentration of these growth factors directly to the site of injury, PRP aims to enhance and expedite the natural healing response.
Like PRP, stem cells can be concentrated and injected into the damaged tissue as a treatment for torn rotator cuffs. Stem cells have regenerative properties, and their introduction into the injured area may support tissue repair.
With or without surgery, one of the most important things you can do after a rotator cuff injury is rest. Your tendon will not reattach to your bone properly if you keep using your shoulder joint.
You should put your arm in a brace or sling as recommended by your doctor. You should also limit heavy lifting or overhead activity until your shoulder pain subsides.
During this period, icing may help with rotator cuff pain treatment.
7. Pain management
Rotator cuff injuries can really ache, so usually ice alone doesn’t cut it for rotator cuff pain treatment. If you need additional help with pain, over-the-counter pain relievers such as acetaminophen or ibuprofen may be helpful.
This is not a long-term solution, and you should speak with your doctor before taking pain relief long-term to avoid any side effects.
8. Steroid injections
Another pain management option for rotator cuff tear treatment is steroid injections. A steroid injection can help if your pain can’t be managed with NSAIDs and is interfering with your sleep or daily activities.
Your doctor will help you decide if steroid injections are right for you. These shots only provide temporary relief, and can actually further weaken your tendon, so they could interfere with the success of surgery.
9. Physical therapy
Whether you have surgery or not, physical therapy is one of the most crucial rotator cuff tear therapies for making a full recovery. Your physical therapist can tailor your exercises to the specific location of your injury, your biology, and how far along you are in the recovery process.
Physical therapy is one of the most effective ways to restore flexibility and strength to your shoulder joint after injury. This, in turn, can help to prevent repeat injuries down the line.
10. Collagen supplements
You may be surprised to see collagen supplements on this list, but they could be a truly impactful rotator cuff tear treatment option for many people. In fact, collagen is one of the very best supplements to heal a rotator cuff tear.
Well, 80% of the dry weight of your tendons is collagen, and collagen protein is what your body needs to repair the torn tissue fibers. That’s why many nutritionists recommend regular collagen supplements as part of medical nutrition therapy for people with injuries.
By providing your body with ample stores of collagen protein, your body will have all the building blocks it needs to create new tendon fibers as efficiently as possible.
And, as long as you purchase a high-quality and easy to absorb supplement, you will get all the other collagen peptides benefits for your body too! These range from healthier skin and hair to reduced joint pain and digestive issues.
Start your road to recovery
Recovering from a torn rotator cuff can be a long and frustrating journey, but with the help of your doctor and a combination of the rotator cuff tear treatments above, you should be able to regain pain-free use of your shoulder joint with time.
Tendons can take an infuriatingly long time to heal, but taking a daily medical-grade collagen supplement is one of the best things you can do to help speed your natural healing process along.